Alendronate increases BMD at appendicular and axial skeletons in patients with established osteoporosis

Journal of Orthopaedic Surgery and Research, May 2007

Background To identify high-risk patients and provide pharmacological treatment is one of the effective approaches in prevention of osteoporotic fractures. This study investigated the effect of 12-month Alendronate treatment on bone mineral density (BMD) and bone turnover biochemical markers in postmenopausal women with one or more non-traumatic fractures, i.e. patients with established osteoporosis. Methods A total of 118 Hong Kong postmenopausal Chinese women aged 50 to 75 with low-energy fracture at distal radius (Colles' fracture) were recruited for BMD measurement at lumbar spine and non-dominant hip using Dual-Energy X-ray Absorptiometry (DXA). 47 women with BMD T-score below -2 SD at either side were identified as patients with established osteoporosis and then randomized into Alendronate group (n = 22) and placebo control group (n = 25) for BMD measurement at spine and hip using DXA and distal radius of the non-fracture side by peripheral quantitative computed tomography (pQCT), and bone turnover markers, including bone forming alkaline phosphatase (BALP) and bone resorbing urinary Deoxypyridinoline (DPD). All measurements were repeated at 6 and 12 months. Results Alendronate treatment significantly increased BMD, more in weight-bearing skeletons (5.1% at spine and 2.5% at hip) than in non-weight bearing skeleton (0.9% at distal radius) after 12 months treatment. Spine T-score was significant improved in Alendronate group (p < 0.01) (from -2.2 to -1.9) but not in control placebo group. The Alendronate treatment effect was explained by significant suppression of bone turnover. Conclusion 12 months Alendronate treatment was effective to increase BMD at both axial and appendicular skeletons in postmenopausal women with established osteoporosis.

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Alendronate increases BMD at appendicular and axial skeletons in patients with established osteoporosis

Journal of Orthopaedic Surgery and Research Alendronate increases BMD at appendicular and axial skeletons in patients with established osteoporosis Ling Qin 0 1 Wingyee Choy 1 Szeki Au 0 Musei Fan 0 Pingchung Leung 0 1 0 Hong Kong Jockey Club Center for Osteoporosis Care and Control, The Chinese University of Hong Kong , Hong Kong SAR , China 1 Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong , Hong Kong SAR , China Background: To identify high-risk patients and provide pharmacological treatment is one of the effective approaches in prevention of osteoporotic fractures. This study investigated the effect of 12-month Alendronate treatment on bone mineral density (BMD) and bone turnover biochemical markers in postmenopausal women with one or more non-traumatic fractures, i.e. patients with established osteoporosis. Methods: A total of 118 Hong Kong postmenopausal Chinese women aged 50 to 75 with lowenergy fracture at distal radius (Colles' fracture) were recruited for BMD measurement at lumbar spine and non-dominant hip using Dual-Energy X-ray Absorptiometry (DXA). 47 women with BMD T-score below -2 SD at either side were identified as patients with established osteoporosis and then randomized into Alendronate group (n = 22) and placebo control group (n = 25) for BMD measurement at spine and hip using DXA and distal radius of the non-fracture side by peripheral quantitative computed tomography (pQCT), and bone turnover markers, including bone forming alkaline phosphatase (BALP) and bone resorbing urinary Deoxypyridinoline (DPD). All measurements were repeated at 6 and 12 months. Results: Alendronate treatment significantly increased BMD, more in weight-bearing skeletons (5.1% at spine and 2.5% at hip) than in non-weight bearing skeleton (0.9% at distal radius) after 12 months treatment. Spine T-score was significant improved in Alendronate group (p < 0.01) (from -2.2 to -1.9) but not in control placebo group. The Alendronate treatment effect was explained by significant suppression of bone turnover. Conclusion: 12 months Alendronate treatment was effective to increase BMD at both axial and appendicular skeletons in postmenopausal women with established osteoporosis. - Background Our recent retrospective study shows that postmenopausal women with low-energy Colles' fractures are associated with osteoporosis [1]. Similar studies are also reported before that osteoporotic fracture is often seen in high risk patients such as those with established osteoporosis, i.e. osteoporotic patients with one or more lowenergy fractures [2-4]. Osteoporotic fracture incurs high morbidity, mortality and healthcare expenditure [3,5-7]. The current consensus for effective prevention of osteoporotic fracture is to identify the high-risk patients and put them on effective pharmacological intervention programs. Anti-resorptive drugs such as Bisphosphonates have been proven to be effective for treatment of osteoporosis and fracture prevention in patients with osteoporosis [7-10]. The aim of this study was to evaluate effects of 12-month Alendronate treatment in postmenopausal women with established osteoporosis. Bone mineral density (BMD) was used as the end-point and bone turnover biochemical markers were evaluated for monitoring bone metabolism in response to drug treatment effects. Methods In order to confirm our treatment effects, we identified patients with established osteoporosis for treatment and used bone mineral density (BMD) at both axial and appendicular skeletons as the end-point for evaluations. Subject recruitment and identification of patients with established osteoporosis One hundred eighteen postmenopausal women, aged 5075 with one low-energy fracture at distal radius (Colles' fracture) in the past 5 years, were concurrently recruited form the hospital of the investigators as described in our recent study [1]. Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research, and that informed consent was obtained. Exclusion criteria were women under hormonal replacement therapy or drug treatment known to affect bone metabolism, with condition such as hypo- or hyperparathyroidism and hypo- or hyperthyroidism, renal or liver disease. In order to avoid the possible adverse effect of Alendronate on gastrointestinal tract, women with history of gastrointestinal tract disease or chronic stomach disease were also excluded [8,9]. All subjects had BMD measurement at lumbar spine (L2-L4) and non-dominant hip (femoral neck) by Dual-Energy X-ray Absorptiometry (DXA) (Norland XR36, Norland Corporation, Fort Atkinson, WI, USA). Patients with established osteoporosis were those found to have T-score below -2 SD at spine or hip [1,6,11]. Finally, a total of around 40%, i.e. 47 subjects were identified and recruited as patients with established osteoporosis (...truncated)


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Ling Qin, Wingyee Choy, Szeki Au, Musei Fan, Pingchung Leung. Alendronate increases BMD at appendicular and axial skeletons in patients with established osteoporosis, Journal of Orthopaedic Surgery and Research, 2007, pp. 9, 2, DOI: 10.1186/1749-799X-2-9