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Endocrine Abstracts (2021) 73 AEP95 | DOI: 10.1530/endoabs.73.AEP95

ECE2021 Audio Eposter Presentations Calcium and Bone (75 abstracts)

High dose short term glucocorticoid (gc) treatment seems to have no long term negative effect on bone mineral density (bmd) of newly diagnosed multiple sclerosis (ms) patients

George Simeakis 1 , Katerina Saltiki 1 , Nikolaos Fakas 2 , John Koutsikos 3 , Kostas Athanasiou 3 , George Papatheodorou 4 , Athanasios Papatheodorou 5 , Evangelia Zapanti 1 , Maria Anagnostouli 6 , Maria Alevizaki 1 & Evangelos Terpos 7

1School of Medicine, National and Kapodistrian University of Athens, Division of Endocrinology Diabetes and Metabolism, Department of Clinical Therapeutics, Athens, Greece; 2401 Military Hospital of Athens, Neurology Department, Athens, Greece; 3401 Military Hospital of Athens, Department of Nuclear Medicine, Athens, Greece; 4401 Military Hospital of Athens, Center for Molecular Biology – Research Unit, Athens, Greece; 5251 Air Force General Hospital, Department for Biomedical Research, Athens, Greece; 6School of Medicine, National and Kapodistrian University of Athens, 1st Neurology Department, Athens, Greece; 7School of Medicine, National and Kapodistrian University of Athens, Department of Clinical Therapeutics, Athens, Greece


High-Dose-Intravenous-Steroid-Treatment-(HDIST) represents the first choice of treatment for MS relapses. Although chronic oral GC-administration is associated with bone loss there are still conflicting data regarding HDIST.


25 newly-diagnosed MS-patients (10-women) were prospectively enrolled meeting the following eligibility criteria: age 18–45 yrs, fully ambulatory, women with normal menstruation. Exclusion criteria: history of any chronic disease, previous GC-treatment in any dosage regimen. Patients received 1000 mg-Methylprednisolone intravenously daily for 5 consecutive days. 7/25pts were excluded due to mobility impairment, 8/25 were lost to follow-up. In the remaining 10pts (6-men) serum levels of: Calcium, Phosphorus, Albumin, Magnesium, Creatinine, 25-OH-D, Parathyroid-Hormone-(PTH), Thyroid-Hormones-(TH), Bone-fraction-Alkaline-Phosphatase-(BALP), N-terminal-propeptide-procollagen-type-1-(P1NP), C-terminal-peptide-type-of-collagen-(CTx), Receptor-Activator-of-Nuclear-Factor-Kappa-β-Ligand-(RANK-L), Osteoprotegerin, Sclerostin, Dickkopf-1-(DKK-1), Periostin, Interleukins-(IL)-1β, 6.17 were determined prior to GC-administration and consecutively the days: 2–4–6-90 and months: 6–12–18–24. BMD of both hips and lumbar spine as well as whole-body measurement of adipose/lean tissue were assessed with Dual-X-ray-Absorptiometry-(DXA)-scan, prior to GC-administration and consecutively every six months.


Bone formation markers, P1NP and BALP, showed an initial non-significant fall (P1NP day 6:–0.414 ± 0.128 ng/ml, BALP day 4:–0.864 ± 0.334 µg/l) followed by a significant increase in day 90 (P1NP: + 0.567 ± 0.13 ng/ml, P < 0.05, BALP: + 1.838 ± 0.464 µg/l, P < 0.05). No other significant changes were observed. A transient non-significant fall of BMD was observed at all sites 6-months after GC-administration, which subsequently appeared to be restored while in the lumbar spine this trend for reduction continued up to 24-months. The percentage changes of Periostin levels from baseline to 24-months correlated positively with the changes in total-left-hip-BMD and left-trochanter-BMD (r =+ 0.709, P = 0.022 and r =+ 0.77, P = 0.009, respectively) and negatively with CTx (r = 0.806, P = 0.005). The changes in CTx levels negatively correlated with the changes in left-trochanter-BMD (r =–0.782, P = 0.008). A positive correlation of the changes in left-femoral-neck-BMD with the changes in Body-Mass-Index-(BMI) was observed (r = +0.661, P = 0.038). The percentage changes of 25-OH-D levels form baseline to 24-months negatively correlated with the changes of IL-1β from baseline to 3 and 6 months (r = –0.806, P = 0.005 and r = –0.867, P = 0.002, respectively).


In spite of the small sample this is the first-to our knowledge-prospective study aiming to elucidate the impact of HDIST on BMD and simultaneously on biochemical parameters of bone metabolism in newly-diagnosed MS-patients; high dose short term GC administration seems to have no long term negative effect on BMD in this group of patients. The observed transient increase in bone formation markers -90 days after GC administration- probably indicates a high bone turnover phase as a ’response’ to the transient adverse effects of GC on bone-metabolism. More prospective studies with larger sample size on similarly selected patients should be performed.

Volume 73

European Congress of Endocrinology 2021

22 May 2021 - 26 May 2021

European Society of Endocrinology 

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