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Monitoring alendronate therapy for osteoporosis.
J Bone Miner Res. 1999 Apr; 14(4):602-8.JB

Abstract

Alendronate is an antiresorptive therapy for osteoporosis and results in a decrease in bone turnover. To choose the optimal measurement for monitoring this therapy, the size of the change needs to be compared with the variability of the measurement. We studied 26 women with postmenopausal osteoporosis (bone mineral density [BMD] T score < -2.5), who were randomized in a 2:1 ratio to receive alendronate (10 mg/day) and calcium carbonate (500 mg/day) or calcium carbonate alone for 6 months. We measured serum markers of bone formation (osteocalcin [OC], bone isoform of alkaline phosphatase [BAP], and collagen type I C-terminal propeptide [CICP]) and urinary markers of bone resorption (cross-linked N-telopeptide [NTx], free deoxypyridinoline [iFDpd], and free pyridinolines). All subjects had two measurements 1 week apart at baseline to calculate the short-term variability. Biochemical measurements were then made at 4, 8, 12, 24, and 25 weeks. Measurements of bone mass were made by dual-energy X-ray absorptiometry (DXA) at the lumbar spine and proximal femur twice at baseline and then at 24 and 25 weeks. The mean difference in change in BMD and markers between both groups at the end of the study that were significant were (short-term variability in brackets): DXA total hip 4.3% (2.5%), NTX 49% (10%), iFDpd 22% (12%), OC 28% (13%), BAP 31% (13%), and CICP 31% (11%). Five of the six markers showed significant responses to alendronate therapy, but they differed in the relationship between size of response and variability. These biochemical markers performed better than DXA for monitoring alendronate therapy over 6 months.

Authors+Show Affiliations

Department of Human Metabolism and Clinical Biochemistry, University of Sheffield, United Kingdom.No affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

10234582

Citation

Braga de Castro Machado, A, et al. "Monitoring Alendronate Therapy for Osteoporosis." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 14, no. 4, 1999, pp. 602-8.
Braga de Castro Machado A, Hannon R, Eastell R. Monitoring alendronate therapy for osteoporosis. J Bone Miner Res. 1999;14(4):602-8.
Braga de Castro Machado, A., Hannon, R., & Eastell, R. (1999). Monitoring alendronate therapy for osteoporosis. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 14(4), 602-8.
Braga de Castro Machado A, Hannon R, Eastell R. Monitoring Alendronate Therapy for Osteoporosis. J Bone Miner Res. 1999;14(4):602-8. PubMed PMID: 10234582.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Monitoring alendronate therapy for osteoporosis. AU - Braga de Castro Machado,A, AU - Hannon,R, AU - Eastell,R, PY - 1999/5/11/pubmed PY - 1999/5/11/medline PY - 1999/5/11/entrez SP - 602 EP - 8 JF - Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research JO - J Bone Miner Res VL - 14 IS - 4 N2 - Alendronate is an antiresorptive therapy for osteoporosis and results in a decrease in bone turnover. To choose the optimal measurement for monitoring this therapy, the size of the change needs to be compared with the variability of the measurement. We studied 26 women with postmenopausal osteoporosis (bone mineral density [BMD] T score < -2.5), who were randomized in a 2:1 ratio to receive alendronate (10 mg/day) and calcium carbonate (500 mg/day) or calcium carbonate alone for 6 months. We measured serum markers of bone formation (osteocalcin [OC], bone isoform of alkaline phosphatase [BAP], and collagen type I C-terminal propeptide [CICP]) and urinary markers of bone resorption (cross-linked N-telopeptide [NTx], free deoxypyridinoline [iFDpd], and free pyridinolines). All subjects had two measurements 1 week apart at baseline to calculate the short-term variability. Biochemical measurements were then made at 4, 8, 12, 24, and 25 weeks. Measurements of bone mass were made by dual-energy X-ray absorptiometry (DXA) at the lumbar spine and proximal femur twice at baseline and then at 24 and 25 weeks. The mean difference in change in BMD and markers between both groups at the end of the study that were significant were (short-term variability in brackets): DXA total hip 4.3% (2.5%), NTX 49% (10%), iFDpd 22% (12%), OC 28% (13%), BAP 31% (13%), and CICP 31% (11%). Five of the six markers showed significant responses to alendronate therapy, but they differed in the relationship between size of response and variability. These biochemical markers performed better than DXA for monitoring alendronate therapy over 6 months. SN - 0884-0431 UR - https://www.unboundmedicine.com/medline/citation/10234582/Monitoring_alendronate_therapy_for_osteoporosis_ L2 - https://doi.org/10.1359/jbmr.1999.14.4.602 DB - PRIME DP - Unbound Medicine ER -