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

Amos Pines, Nachman Eckstein, Gideon Kopernik, Daniel Ayalon, Doron Comaneshter, Yair Frenkel

Research output: Contribution to journalArticlepeer-review

Abstract

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/cm2, with a t-score of -2.75±0.8 S.D., and femoral neck density 0.706±0.085 g/cm2 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.

Original languageEnglish
Pages (from-to)287-292
Number of pages6
JournalMaturitas
Volume44
Issue number4
DOIs
StatePublished - 25 Apr 2003
Externally publishedYes

Keywords

  • Alendronate
  • HRT
  • Menopause
  • Osteoporosis

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