Document Detail


Month 3 and month 6 measurements of bone mineral density predict the annual outcome in postmenopausal women with osteoporosis in whom alendronate was added to long-term HRT.
MedLine Citation:
PMID:  12697369     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To examine the predictive value of bone mineral density measurements done as early as months 3 and 6 after initiation of alendronate therapy (10 mg daily) in osteoporotic women already using long-term hormone replacement therapy. METHOD: Lumbar spine and femoral neck bone density (DPX by Lunar) were performed at baseline, 3, 6, 12 months of combined therapy. The study group included 45 women at baseline, but 2 dropped-out at day 67 and at month 6 because of gastric complaints, leaving 43 women for analyses. RESULTS: Group characteristics at baseline were as follows: mean age 61+/-5 years, mean duration of HRT use 7+/-3 years, lumbar spine bone density 0.863+/-0.089 g/cm(2), with a t-score of -2.75+/-0.8 S.D., and femoral neck density 0.706+/-0.085 g/cm(2) with a t-score of -2.28+/-0.7 S.D. Bone density increased during 1 year of combined therapy, totaling a 3.2% gain for the spine and a 2.4% gain for the femur. Most of the annual change was already observed at month 3: 2.1% for the spine and 1.4% for the femur. Moreover, the baseline to month 6 percentage difference showed a very good correlation with the yearly outcome (r=0.74, P<0.001 for both spine and femur). When different arbitrary cut-off definitions for a successful treatment (1%, 1.5% or 2% gain in density) were used in analyses, in the majority of cases the bone density at 1 year, whether elevated or not, could be predicted by months 3 and 6 results. Although urine deoxypyridinoline decreased throughout the study period, demonstrating a significant time trend (P=0.001), the baseline to month 3 changes did not correlate with baseline to annual bone density results. CONCLUSIONS: In specific clinical settings when patients or physicians are looking for a good way to anticipate whether additional alendronate in hormone users would turn out to be beneficial, bone density measurements performed as early as 3-6 months after initiation of therapy might give the answer.
Authors:
Amos Pines; Nachman Eckstein; Gideon Kopernik; Daniel Ayalon; Doron Comaneshter; Yair Frenkel
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Maturitas     Volume:  44     ISSN:  0378-5122     ISO Abbreviation:  Maturitas     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-04-16     Completed Date:  2003-10-09     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7807333     Medline TA:  Maturitas     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  287-92     Citation Subset:  IM    
Affiliation:
Menopause Clinic, Ramat Marpe Hospital, Ramat Gan, Ichilov Hospital, Tel-Aviv, and Sheba Medical Center, Tel-Hashomer, Israel. apines@netvision.net.il
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MeSH Terms
Descriptor/Qualifier:
Absorptiometry, Photon
Alendronate / therapeutic use*
Bone Density / drug effects*
Drug Therapy, Combination
Estrogen Replacement Therapy*
Female
Femur Neck / radiography
Humans
Lumbar Vertebrae / radiography
Middle Aged
Osteoporosis, Postmenopausal / metabolism,  prevention & control*
Predictive Value of Tests
Chemical
Reg. No./Substance:
66376-36-1/Alendronate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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