Prevention of bone loss with alendronate

Prevention of bone loss with alendronate - The New England...

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Volume 338 Number 8 ± 485 The New England Journal of Medicine © Copyright, 1998, by the Massachusetts Medical Society VOLUME 338 F EBRUARY 19, 1998 NUMBER 8 PREVENTION OF BONE LOSS WITH ALENDRONATE IN POSTMENOPAUSAL WOMEN UNDER 60 YEARS OF AGE D AVID H OSKING , M.D., C LAIR E.D. C HILVERS , D.S C ., C LAUS C HRISTIANSEN , M.D., P ERNILLE R AVN , M.D., R ICHARD W ASNICH , M.D., P HILIP R OSS , P H .D., M ICHAEL M C C LUNG , M.D., A NA B ALSKE , M.D., P H .D., D ESMOND T HOMPSON , P H .D., M ARIANNE D ALEY , B.A., AND A. J OHN Y ATES , M.D., FOR THE E ARLY P OSTMENOPAUSAL I NTERVENTION C OHORT S TUDY G ROUP * A BSTRACT Background Estrogen-replacement therapy pre- vents osteoporosis in postmenopausal women by inhibiting bone resorption, but the balance between its long-term risks and benefits remains unclear. Whether other antiresorptive therapies can prevent osteoporosis in these women is also not clear. Methods We studied the effect of 2.5 mg or 5 mg of alendronate per day or placebo on bone mineral density in 1174 postmenopausal women under 60 years of age. An additional 435 women who were prepared to receive a combination of estrogen and progestin were randomly assigned to one of the above treatments or open-label estrogen–progestin. The main outcome measure was the change in bone mineral density of the lumbar spine, hip, distal fore- arm, and total body measured annually for two years by dual-energy x-ray absorptiometry. Results The women who received placebo lost bone mineral density at all measured sites, whereas the women treated with 5 mg of alendronate daily had a mean ( ± SE) increase in bone mineral density of 3.5 ± 0.2 percent at the lumbar spine, 1.9 ± 0.1 per- cent at the hip, and 0.7 ± 0.1 percent for the total body (all P ² 0.001). Women treated with 2.5 mg of alendro- nate daily had smaller increases in bone mineral den- sity. Alendronate did not increase bone mineral density of the forearm, but it slowed the loss. The re- sponses to estrogen–progestin were 1 to 2 percent- age points greater than those to the 5-mg dose of alendronate. Alendronate was well tolerated, with a safety profile similar to that of placebo or estrogen– progestin. Conclusions Alendronate prevents bone loss in postmenopausal women under 60 years of age to nearly the same extent as estrogen–progestin. (N Engl J Med 1998;338:485-92.) ©1998, Massachusetts Medical Society. From the Division of Mineral Metabolism, City Hospital (D.H.), and the School of Community Health Sciences, University of Nottingham Medical School (C.E.D.C.), Nottingham, United Kingdom; the Center for Clinical and Basic Research, Ballerup, Denmark (C.C., P. Ravn); the Hawaii Osteoporosis Center, Honolulu (R.W., P. Ross); Oregon Osteoporosis Center, Providence Health System, Portland (M.M., A.B.); and Merck Re- search Laboratories, Rahway, N.J. (D.T., M.D., A.J.Y.). Address reprint re- quests to Dr. Hosking at the Division of Mineral Metabolism, City Hospi- tal, Hucknall Rd., Nottingham NG5 1PB, United Kingdom.
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This note was uploaded on 06/08/2009 for the course BCH 120 taught by Professor Luben,norman,henry during the Spring '09 term at UC Riverside.

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Prevention of bone loss with alendronate - The New England...

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