BACKGROUND:Patients with airways disease have been demonstrated to be at risk of osteoporosis, and this is likely to be multifactorial. Our aim was to identify patients with low bone mineral density (BMD) using a screening program, and then evaluate the benefit of daily alendronate. METHOD: Subjects with hip or lumbar spine baseline T-scores < - 2.5, or Z-score < - 1.0 commenced onalendronate/calcium (10 mg/600 mg day) orplacebo/calcium, in a double blind randomized controlled trial. BMD by dual emission X-ray absorptiometry (lumbar vertebrae 2-4, neck of femur, total femur) was repeated after 12 months, with adverse events recorded. RESULTS:145 subjects (74 male, 71 female, mean age 67, median FEV1 1.0 litres = 43% of predicted) were enrolled; 66alendronate/calcium, 79 placebo/calciumwith 24 and 26 withdrawals, respectively. Per protocol but not intention to treat analysis of covariance demonstrated statistically significant improvements in T and Z scores for lumbar spine bone mineral density (P = 0.035, P = 0.040), with no improvement demonstrated at the hip. CONCLUSIONS: Improvement in bone mineral density has been demonstrated at the lumbar spine, but not hip, by per protocol analysis, with daily alendronate, at 12 months.
RCT Entities:
BACKGROUND:Patients with airways disease have been demonstrated to be at risk of osteoporosis, and this is likely to be multifactorial. Our aim was to identify patients with low bone mineral density (BMD) using a screening program, and then evaluate the benefit of daily alendronate. METHOD: Subjects with hip or lumbar spine baseline T-scores < - 2.5, or Z-score < - 1.0 commenced on alendronate/calcium (10 mg/600 mg day) or placebo/calcium, in a double blind randomized controlled trial. BMD by dual emission X-ray absorptiometry (lumbar vertebrae 2-4, neck of femur, total femur) was repeated after 12 months, with adverse events recorded. RESULTS: 145 subjects (74 male, 71 female, mean age 67, median FEV1 1.0 litres = 43% of predicted) were enrolled; 66 alendronate/calcium, 79 placebo/calcium with 24 and 26 withdrawals, respectively. Per protocol but not intention to treat analysis of covariance demonstrated statistically significant improvements in T and Z scores for lumbar spine bone mineral density (P = 0.035, P = 0.040), with no improvement demonstrated at the hip. CONCLUSIONS: Improvement in bone mineral density has been demonstrated at the lumbar spine, but not hip, by per protocol analysis, with daily alendronate, at 12 months.
Authors: Sarah Davis; Emma Simpson; Jean Hamilton; Marrissa Martyn-St James; Andrew Rawdin; Ruth Wong; Edward Goka; Neil Gittoes; Peter Selby Journal: Health Technol Assess Date: 2020-06 Impact factor: 4.014
Authors: In Seon Lee; Ah Young Leem; Sang Hoon Lee; Yumie Rhee; Yoon Ha; Young Sam Kim Journal: Korean J Intern Med Date: 2016-09-01 Impact factor: 2.884
Authors: Ayushman Gupta; Leah R Jayes; Steve Holmes; Opinder Sahota; Melissa Canavan; Sarah L Elkin; Kelvin Lim; Anna C Murphy; Sally Singh; Elizabeth A Towlson; Helen Ward; Jane Scullion; Tricia M McKeever; Charlotte E Bolton Journal: Int J Chron Obstruct Pulmon Dis Date: 2020-06-15