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

Respiratory Research

Thyge L. Nielsen¹  Kristoffer Marså²  Niklas R. Jørgensen³  Ulla M. Weinreich⁴  Nina Godtfredsen⁵  Charlotte Suppli Ulrik⁵  Helle F. Andreassen⁶  Julie Janner⁶  Therese Lapperre⁶  Niels Seersholm⁷  Tobias W. Klausen⁸  Jørgen Vestbo⁹  Praleene Sivapalan^1,10  Karin Armbruster^1,10  Josefin Eklöf^1,10  Torgny Wilcke^1,10  Pradeesh Sivapalan^1,10  Philipp Schuetz^1,10  Alexander G. Mathioudakis^1,11  Jens-Ulrik Jensen^1,11 

[1]The Clinical Institute, Aalborg University

[2]Clinical Research Unit, Department of Hematology, Herlev Hospital

[3]Department of Clinical Biochemistry, Copenhagen University Hospital Rigshospitalet

[4]Department of Respiratory Diseases, Aalborg University Hospital, Aalborg, Denmark

[5]Department of Respiratory Medicine, Amager and Hvidovre University Hospital

[6]Department of Respiratory Medicine, Bispebjerg University Hospital

[7]Department of Respiratory and Infectious Diseases, Frederiksund and Hillerød Hospital, University of Copenhagen

[8]Medical University Department, Kantonsspital Aarau

[9]Palliative Medicine Section Unit, Herlev and Gentofte Hospital

[10]Section of Respiratory Medicine, Department of Medicine, Herlev and Gentofte Hospital, University of Copenhagen

[11]The North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust

关键词: Adverse effects;    Bone remodelling;    Bone turnover markers;    Chronic obstructive pulmonary disease;    Corticosteroids;   

DOI  :  10.1186/s12931-020-01531-9

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown