Bone turnover biomarkers in COPD patients randomized to either a regular or shortened course of corticosteroids: a substudy of the randomized controlled CORTICO-COP trial
Posted on 2020-10-13 - 03:28
Abstract Background Long-term treatment with corticosteroids causes loss of bone density, but the effects of using short-term high-dose systemic-corticosteroid therapy to treat acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are unclear. Our aim was to determine whether high-dose corticosteroid therapy affected bone turnover markers (BTMs) to a greater extent compared to low-dose corticosteroid therapy. Methods The CORTICO-COP trial (NCT02857842) showed that an eosinophil-guided corticosteroid intervention led to approximately 60% lower accumulated corticosteroid dose for hospitalized patients with AECOPD (low-dose group) compared with 5-day standard corticosteroid treatment (high-dose group). We compared the levels of BTMs C-terminal telopeptide of type 1 collagen (CTX) and procollagen type 1 N-terminal propeptide (P1NP) in 318 participants during AECOPD and at 1- and 3-month follow-up visits. Results CTX decreased and P1NP increased significantly over time in both treatment groups. There were no significant differences between the groups at 1- or 3-months follow-up for P1NP. A significant drop in CTX was seen at 3 months (down Δ24% from the baseline, p = 0.017) for the high dose group. Conclusion Short-term, high-dose systemic corticosteroid treatment caused a rapid suppression of biomarkers of bone resorption. Corticosteroids did not suppress biomarkers of bone formation, regardless of patients receiving low or high doses of corticosteroids. This therapy was, therefore, harmless in terms of bone safety, in our prospective series of COPD patients. Trial registration ClinicalTrials.gov Identifier: NCT02857842 . Submitted August 2nd, 2016.
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Sivapalan, Pradeesh; Jørgensen, Niklas R.; Mathioudakis, Alexander G.; Eklöf, Josefin; Lapperre, Therese; Ulrik, Charlotte Suppli; et al. (2020). Bone turnover biomarkers in COPD patients randomized to either a regular or shortened course of corticosteroids: a substudy of the randomized controlled CORTICO-COP trial. figshare. Collection. https://doi.org/10.6084/m9.figshare.c.5173025.v1
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AUTHORS (20)
PS
Pradeesh Sivapalan
NJ
Niklas R. Jørgensen
AM
Alexander G. Mathioudakis
JE
Josefin Eklöf
TL
Therese Lapperre
CU
Charlotte Suppli Ulrik
HA
Helle F. Andreassen
KA
Karin Armbruster
PS
Praleene Sivapalan
JJ
Julie Janner
NG
Nina Godtfredsen
UW
Ulla M. Weinreich
TN
Thyge L. Nielsen
NS
Niels Seersholm
TW
Torgny Wilcke
PS
Philipp Schuetz
TK
Tobias W. Klausen
KM
Kristoffer Marså
JV
Jørgen Vestbo
JJ
Jens-Ulrik Jensen