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Change in bone turnover and hip, non-spine, and vertebral fracture in alendronate-treated women: the fracture intervention trial.

Abstract

We used data from the Fracture Intervention Trial to assess the relationship change in bone turnover after 1 year of alendronate or placebo treatment and subsequent hip, non-spine, and spine fracture risk among 6186 postmenopausal women. In the alendronate group (n = 3105), greater reductions in one or more biochemical marker were associated with a lower risk of fracture.

INTRODUCTION

There are few data on the relationship between short-term change in biochemical markers of bone turnover and non-spine fracture risk among bisphosphonate-treated women, and the clinical use of such measurements is unknown.

MATERIALS AND METHODS

We measured biochemical markers of bone turnover (bone-specific alkaline phosphatase [bone ALP], intact N-terminal propeptide of type I collagen, and C-terminal crosslinked telopeptide of type 1 collagen) and BMD of the spine and hip at baseline and after 1 year of alendronate or placebo. During a mean follow-up of 3.6 years, 72 hip, 786 non-spine, and 336 vertebral fractures were documented.

RESULTS AND CONCLUSIONS

Each 1 SD reduction in 1-year change in bone ALP was associated with fewer spine (odds ratio = 0.74; CI: 0.63, 0.87), non-spine (relative hazard [RH] = 0.89; CI: 0.78, 1.00; p < 0.050), and hip fractures (RH = 0.61; CI: 0.46, 0.78). Alendronate-treated women with at least a 30% reduction in bone ALP had a lower risk of non-spine (RH = 0.72; CI: 0.55, 0.92) and hip fractures (RH = 0.26; CI: 0.08, 0.83) relative to those with reductions <30%. We conclude that greater reductions in bone turnover with alendronate therapy are associated with fewer hip, non-spine, and vertebral fractures, and the effect is at least as strong as that observed with 1-year change in BMD.

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  • Authors+Show Affiliations

    ,

    Department of Medicine, Epidemiology and Biostatistics, University of California, San Francisco, California 94105, USA. dbauer@psf.ucsf.edu

    , , , , , , , ,

    Source

    MeSH

    Aged
    Aged, 80 and over
    Alendronate
    Alkaline Phosphatase
    Biomarkers
    Bone Density
    Bone and Bones
    Collagen
    Collagen Type I
    Double-Blind Method
    Female
    Fractures, Bone
    Hip Fractures
    Humans
    Logistic Models
    Middle Aged
    Patient Selection
    Pelvic Bones
    Peptide Fragments
    Peptides
    Procollagen
    Risk Factors
    Spinal Fractures
    Spine
    Treatment Outcome

    Pub Type(s)

    Clinical Trial
    Journal Article
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    15231011

    Citation

    Bauer, Douglas C., et al. "Change in Bone Turnover and Hip, Non-spine, and Vertebral Fracture in Alendronate-treated Women: the Fracture Intervention Trial." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 19, no. 8, 2004, pp. 1250-8.
    Bauer DC, Black DM, Garnero P, et al. Change in bone turnover and hip, non-spine, and vertebral fracture in alendronate-treated women: the fracture intervention trial. J Bone Miner Res. 2004;19(8):1250-8.
    Bauer, D. C., Black, D. M., Garnero, P., Hochberg, M., Ott, S., Orloff, J., ... Delmas, P. D. (2004). Change in bone turnover and hip, non-spine, and vertebral fracture in alendronate-treated women: the fracture intervention trial. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 19(8), pp. 1250-8.
    Bauer DC, et al. Change in Bone Turnover and Hip, Non-spine, and Vertebral Fracture in Alendronate-treated Women: the Fracture Intervention Trial. J Bone Miner Res. 2004;19(8):1250-8. PubMed PMID: 15231011.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Change in bone turnover and hip, non-spine, and vertebral fracture in alendronate-treated women: the fracture intervention trial. AU - Bauer,Douglas C, AU - Black,Dennis M, AU - Garnero,Patrick, AU - Hochberg,Marc, AU - Ott,Susan, AU - Orloff,John, AU - Thompson,Desmond E, AU - Ewing,Susan K, AU - Delmas,Pierre D, AU - ,, Y1 - 2004/05/24/ PY - 2003/10/14/received PY - 2004/04/06/revised PY - 2004/04/21/accepted PY - 2004/7/3/pubmed PY - 2005/3/17/medline PY - 2004/7/3/entrez SP - 1250 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 - 19 IS - 8 N2 - UNLABELLED: We used data from the Fracture Intervention Trial to assess the relationship change in bone turnover after 1 year of alendronate or placebo treatment and subsequent hip, non-spine, and spine fracture risk among 6186 postmenopausal women. In the alendronate group (n = 3105), greater reductions in one or more biochemical marker were associated with a lower risk of fracture. INTRODUCTION: There are few data on the relationship between short-term change in biochemical markers of bone turnover and non-spine fracture risk among bisphosphonate-treated women, and the clinical use of such measurements is unknown. MATERIALS AND METHODS: We measured biochemical markers of bone turnover (bone-specific alkaline phosphatase [bone ALP], intact N-terminal propeptide of type I collagen, and C-terminal crosslinked telopeptide of type 1 collagen) and BMD of the spine and hip at baseline and after 1 year of alendronate or placebo. During a mean follow-up of 3.6 years, 72 hip, 786 non-spine, and 336 vertebral fractures were documented. RESULTS AND CONCLUSIONS: Each 1 SD reduction in 1-year change in bone ALP was associated with fewer spine (odds ratio = 0.74; CI: 0.63, 0.87), non-spine (relative hazard [RH] = 0.89; CI: 0.78, 1.00; p < 0.050), and hip fractures (RH = 0.61; CI: 0.46, 0.78). Alendronate-treated women with at least a 30% reduction in bone ALP had a lower risk of non-spine (RH = 0.72; CI: 0.55, 0.92) and hip fractures (RH = 0.26; CI: 0.08, 0.83) relative to those with reductions <30%. We conclude that greater reductions in bone turnover with alendronate therapy are associated with fewer hip, non-spine, and vertebral fractures, and the effect is at least as strong as that observed with 1-year change in BMD. SN - 0884-0431 UR - https://www.unboundmedicine.com/medline/citation/15231011/Change_in_bone_turnover_and_hip_non_spine_and_vertebral_fracture_in_alendronate_treated_women:_the_fracture_intervention_trial_ L2 - https://doi.org/10.1359/JBMR.040512 DB - PRIME DP - Unbound Medicine ER -