Effect of Alendronate on Vertebral Fracture Risk in Women With Bone Mineral Density T Scores of-1.6 to -23 at the Femoral Neck: The Fracture Intervention Trial

Quandt, Sara A.; Thompson, Desmond E.; Schneider, Diane L.; Nevitt, Michael C.; Black, Dennis M.
March 2005
Mayo Clinic Proceedings;Mar2005, Vol. 80 Issue 3, p343
Academic Journal
OBJECTIVES: To determine the efficacy of alendronate treatment on risk of vertebral fracture in a subgroup of women from the Fracture Intervention Trial who had bone mineral density T scores between -1.6 and -2.5 at the femoral neck and to describe how soon after initiation of therapy alendronate becomes effective and whether It is consistent in women with and without existing radiographic vertebral fracture. PATIENTS AND METHODS: From May 1992 to March 1997, postmenopausal women aged 55 to 80 years were randomized to receive alendronate at 5 mg/d for 2 years and 10 mg/d thereafter or placebo for up to 4.5 years (mean, 3.8 years) in a controlled, double-blind, multicenter study. RESULTS: A total of 3737 postmenopausal women were included in the study, 1878 in the alendronate group and 1859 in the placebo group. Risk of vertebral fracture was significantly reduced by alendronate compared with placebo for clinical (relative risk [RR], 0.40; 95% confidence interval [CI], 0.19–0.76; P=.005) and radiographic (RR, 0.57; 95% CI, 0.41–0.81; P=.002) fracture. The reductions In vertebral fracture risk were consistent in women with and without an existing radiographic vertebral fracture for clinical (RR, 0.34; 95% CI, 0.12–0.84; and RR, 0.46; 95% CI, 0.16–1.17; respectively) and radiographic (RR, 0.53; 95% CI, 0.34–0.82; and RR, 0.64; 95% CI, 0.3S-1.10; respectively) fractures. In both groups, the effect of alendronate on clinical vertebral fracture was noted soon after therapy was Initiated. The absolute risk of vertebral fracture was low in women without a baseline radiographic fracture. CONCLUSIONS: In women with low bone mass who do not meet the bone mineral density criterion for osteoporosis, alendronate is effective In reducing the risk of vertebral fractures. The absolute benefit of this therapy in women with a T score between -1.6 and -2.5 Is greater In women with an existing vertebral fracture and/or with other risk factors. The effect of alendronate occurs early.


Related Articles

  • High secondary displacement rate in the conservative treatment of impacted femoral neck fractures in 105 patients. Verheyen, Cees; Smulders, Tom; Walsum, Ariaan; Verheyen, Cees C P M; Smulders, Tom C; van Walsum, Ariaan D P // Archives of Orthopaedic & Trauma Surgery;Apr2005, Vol. 125 Issue 3, p166 

    Introduction: The purpose of this retrospective study was to evaluate the dislocation rate after the conservative treatment of impacted femoral neck fractures in four hospitals with the same treatment protocol of partial weight-bearing when tolerated. Patients and Methods:...

  • The accuracy of historical height loss for the detection of vertebral fractures in postmenopausal women. Siminoski, K.; Warshawski, R. S.; Jen, H.; Lee, K. // Osteoporosis International;Feb2006, Vol. 17 Issue 2, p290 

    Historical height loss (HHL) can be calculated as the difference between a patient’s tallest recalled height (TRH) and the current measured height (MH). We have examined the accuracy of HHL as a clinical test for the detection of prevalent vertebral fractures. Subjects were postmenopausal...

  • Vertebral Fracture and Cortical Bone Changes in Corticosteroid-Induced Osteoporosis. Tsugeno, H.; Fujita, T.; Goto, B.; Sugishita, T.; Hosaki, Y.; Ashida, K.; Mitsunobu, F.; Tanizaki, Y.; Shiratori, Y. // Osteoporosis International;Aug2002, Vol. 13 Issue 8, p650 

    : Despite an intriguing understanding of trabecular bone dynamics, little is known about corticosteroid-induced cortical bone loss and fractures. Recently, we verified a steroid-induced decrease in cortical bone volume and density using peripheral quantitative computed tomography (pQCT) in adult...

  • Is Distal Forearm Fracture in Men due to Osteoporosis? Tuck, S. P.; Raj, N.; Summers, G. D. // Osteoporosis International;Aug2002, Vol. 13 Issue 8, p630 

    : Although widely regarded as a disease of women, osteoporosis does cause considerable morbidity and mortality in men. The lifetime risk of an osteoporortic fracture for a man is 1 in 12 and 30% of all hip fractures occur in men. In women, low-trauma distal forearm fracture is widely regarded as...

  • Effect of Ovariectomy, Malnutrition and Glucocorticoid Application on Bone Properties in Sheep: A Pilot Study. Lill, C. A.; Fluegel, A. K.; Schneider, E. // Osteoporosis International;Jun2002, Vol. 13 Issue 6, p480 

    : The demographic changes in the human population continue to lead to an increasing incidence of osteoporosis. The main clinical symptom of osteoporosis is fracture. Fracture fixation in osteoporosis is frequently complicated by failure of fixation. There is a great need for a large-animal model...

  • FRAGILITY FRACTURE: WHAT IS IT AND WHAT CAN WE DO? M. M., Darhaysyam Al Jefri; F., Emil; Y., Ahmad Sallehudin // Malaysian Journal of Medical Sciences;Jan2008 Supplement, p247 

    Introduction : Osteoporosis is defined as a systemic skeletal disease characterized by low bone mass and micro-architectural deterioration of bone tissue, which consequent increase in bone fragility and susceptibility to fracture. Osteoporosis related fracture or fragility fracture has been...

  • Bisphosphonates for the Treatment of Postmenopausal Osteoporosis: Clinical Studies of Etidronate and Alendronate. Harris, S. T. // Osteoporosis International;Dec2001 Supplement 3, Vol. 12, pS11 

    The article reports on treatment of Postmenopausal Osteoporosis. It states that in the United States, osteoporotic fractures account for more than 400,000 hospital admissions and an estimated 13.8 billion U.S. dollar in health care costs each year. Thus, the use of alendronate for the treatment...

  • Special Topic: Risk Factors: Risk Factors For Osteoporosis and Associated Fractures. Kelsey, Jennifer L. // Public Health Reports;Sep/Oct89 Supplement, Vol. 104, p14 

    Established risk factors for osteoporosis and associated fractures are increasing age, female sex, white race, removal of the ovaries at an early age, prolonged immobility, and prolonged use of corticosteroids. Obesity and use of estrogen replacement therapy are protective. Factors that probably...

  • Sustained-release rhBMP-2 increased bone mass and bone strength in an ovine model of postmenopausal osteoporosis. Zi Xiang Wu; Da Liu; Shi Yong Wan; Geng Cui; Yang Zhang; Wei Lei // Journal of Orthopaedic Science;Jan2011, Vol. 16 Issue 1, p99 

    Objective: The purpose of this study was to analyze the local treatment effects of rhBMP-2 combined with fibrin sealant (FS) on bone mineral density, microarchitectural and mechanical properties in osteoporotic ovine spine. Materials and methods: Postmenopausal osteoporosis was induced in eight...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics