Literature DB >> 15883637

Effect of alendronate on the age-specific incidence of symptomatic osteoporotic fractures.

Marc C Hochberg1, Desmond E Thompson, Dennis M Black, Sara A Quandt, Jane Cauley, Piet Geusens, Philip D Ross, Dan Baran.   

Abstract

UNLABELLED: Analyses of data from 3658 postmenopausal women with osteoporosis enrolled in the Fracture Intervention Trial showed that alendronate is effective in reducing the risk of symptomatic osteoporotic fractures across a spectrum of ages.
INTRODUCTION: Most osteoporosis studies examine the relative risk of fracture based on the entire duration of treatment. Because older patients tend to be at higher risk for osteoporosis-related fractures, this analysis examined the effect of alendronate treatment on the relative risk of fracture in terms of the age that patients attained during the study.
MATERIALS AND METHODS: We studied 3658 postmenopausal women with osteoporosis 55-80 years of age at baseline enrolled in the Fracture Intervention Trial, a large randomized, double-blind, placebo-controlled study. Patients were treated with placebo or with alendronate at a daily dose of 5 mg for 2 years followed by 10 mg for an additional 1-2.5 years, and monitored for clinical fractures. Age, rather than study time, was the dynamic variable in our analysis.
RESULTS: The relative risk reductions for hip, clinical spine, and wrist fractures were constant across age groups, without evidence of a decline at older ages. Specifically, alendronate reduced the risk of clinical fracture by 53% at the hip (relative risk [RR] = 0.47; 95% CI = 0.27-0.81; p < 0.01), 45% at the spine (RR = 0.55; 95% CI = 0.37-0.83; p < 0.01), and 31% at the wrist (RR = 0.69; 95% CI = 0.50-0.98; p = 0.038). In addition, alendronate produced a significant risk reduction of 40% (RR = 0.60; 95% CI = 0.47-0.77; p < 0.01) for the composite event of clinical hip, spine, and wrist fractures. As a consequence of the constant relative risk model, the absolute risk reduction with alendronate treatment increased with age because of the age-related increase in fracture risk in the placebo group. The absolute risk reduction for the composite event (hip, spine, and wrist fractures together) for alendronate treatment versus placebo was 65, 80, 111, and 161 women with fractures per 10,000 PYR for the 55 to <65, 65 to <70, 70 to <75, and 75-85 year age groups, respectively.
CONCLUSIONS: These data show that alendronate is effective in reducing the risk of symptomatic osteoporotic fractures across a spectrum of ages. The effectiveness is somewhat greater in patients with femoral neck T score < or = -2.5 than in those with a T score < or = -2.0.

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Year:  2005        PMID: 15883637     DOI: 10.1359/JBMR.050104

Source DB:  PubMed          Journal:  J Bone Miner Res        ISSN: 0884-0431            Impact factor:   6.741


  32 in total

Review 1.  Efficacy of antiresorptive agents for preventing fractures in Japanese patients with an increased fracture risk: review of the literature.

Authors:  Jun Iwamoto; Yoshihiro Sato; Tsuyoshi Takeda; Hideo Matsumoto
Journal:  Drugs Aging       Date:  2012-03-01       Impact factor: 3.923

2.  Effect of Bisphosphonates on Fracture Outcomes Among Frail Older Adults.

Authors:  Andrew R Zullo; Tingting Zhang; Yoojin Lee; Kevin W McConeghy; Lori A Daiello; Douglas P Kiel; Vincent Mor; Sarah D Berry
Journal:  J Am Geriatr Soc       Date:  2018-12-21       Impact factor: 5.562

3.  Overdiagnosis of osteoporosis: fact or fallacy?

Authors:  J Compston
Journal:  Osteoporos Int       Date:  2015-07-02       Impact factor: 4.507

4.  Bisphosphonates for the treatment of osteoporosis: insights for clinicians.

Authors:  E Michael Lewiecki
Journal:  Ther Adv Chronic Dis       Date:  2010-05       Impact factor: 5.091

5.  Hip and fragility fracture prediction by 4-item clinical risk score and mobile heel BMD: a women cohort study.

Authors:  Daniel Albertsson; Dan Mellström; Christer Petersson; Hans Thulesius; Robert Eggertsen
Journal:  BMC Musculoskelet Disord       Date:  2010-03-24       Impact factor: 2.362

6.  Characteristics of patients who suffer major osteoporotic fractures despite adhering to alendronate treatment: a National Prescription registry study.

Authors:  B Abrahamsen; K H Rubin; P A Eiken; R Eastell
Journal:  Osteoporos Int       Date:  2012-10-16       Impact factor: 4.507

7.  Effect of alendronate on bone metabolic indices and bone mineral density in patients treated with high-dose glucocorticoid: a prospective study.

Authors:  H Kaji; Y Kuroki; Y Murakawa; I Funakawa; Y Funasaka; F Kanda; T Sugimoto
Journal:  Osteoporos Int       Date:  2009-11-17       Impact factor: 4.507

Review 8.  Hip fracture protection by alendronate treatment in postmenopausal women with osteoporosis: a review of the literature.

Authors:  Jun Iwamoto; Yoshihiro Sato; Tsuyoshi Takeda; Hideo Matsumoto
Journal:  Clin Interv Aging       Date:  2008       Impact factor: 4.458

Review 9.  Diagnosis and management of osteoporosis in the older senior.

Authors:  Sheryl F Vondracek; Sunny A Linnebur
Journal:  Clin Interv Aging       Date:  2009-05-14       Impact factor: 4.458

10.  Comparison of the effects of alendronate and alfacalcidol on hip bone mineral density and bone turnover in Japanese men having osteoporosis or osteopenia with clinical risk factors for fractures.

Authors:  Jun Iwamoto; Yoshihiro Sato; Mitsuyoshi Uzawa; Tsuyoshi Takeda; Hideo Matsumoto
Journal:  Yonsei Med J       Date:  2009-08-19       Impact factor: 2.759

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