Bone turnover biomarkers in COPD patients randomized to either a regular or shortened course of corticosteroids: a subst
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RESEARCH
Open Access
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 Pradeesh Sivapalan1,2* , Niklas R. Jørgensen3,4, Alexander G. Mathioudakis5,6, Josefin Eklöf1, Therese Lapperre7, Charlotte Suppli Ulrik8, Helle F. Andreassen7, Karin Armbruster1, Praleene Sivapalan1, Julie Janner7, Nina Godtfredsen8, Ulla M. Weinreich9, Thyge L. Nielsen10, Niels Seersholm1, Torgny Wilcke1, Philipp Schuetz11,12, Tobias W. Klausen13, Kristoffer Marså14, Jørgen Vestbo5,6 and Jens-Ulrik Jensen1,4
Abstract Background: Long-term treatment with corticosteroids causes loss of bone density, but the effects of using shortterm 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. (Continued on next page)
* Correspondence: [email protected] 1 Section of Respiratory Medicine, Department of Medicine, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte Hospitalsvej 7, Ground Floor, DK-2900 Hellerup, Denmark 2 Department of Internal Medicine, Zealand Hospital, University of Copenhagen, Roskilde, Denmark Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this lic
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