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Early changes in biochemical markers of bone turnover are associated with long-term changes in bone mineral density in elderly women on alendronate, hormone replacement therapy, or combination therapy: a three-year, double-blind, placebo-controlled, randomized clinical trial.
J Clin Endocrinol Metab. 2005 May; 90(5):2762-7.JC

Abstract

Elderly women on combination therapy with alendronate and hormone replacement for osteoporosis have greater gains in bone mass than those on monotherapy. It is not known whether early changes in markers can predict the long-term changes in bone density with therapy. We assessed bone density and biochemical markers of bone turnover [urine N-telopeptide cross-linked collagen type 1 (NTx), serum bone-specific alkaline phosphatase, and osteocalcin] every 6 months for 3 yr in a double-blind, placebo-controlled, randomized clinical trial. After a 3-month run-in phase, 373 community-dwelling, elderly women were randomized to 1) alendronate, 2) hormone replacement therapy, 3) combination therapy with alendronate and hormone replacement therapy, or 4) placebo. Women on active treatment with the greatest decrease in markers of bone turnover at 6 months had the greatest increases in spine and hip bone density at 3 yr. The response to alendronate was generally associated with greater reductions in markers than the response to hormone replacement and was associated with greater increases in bone density at the spine and hip. Those in the tertile with the greatest decrease in urinary NTx had a 10.1% increase in spine bone density and a 6.1% increase in hip bone density compared with those in the lowest tertile, who had a 5.9% increase in spine bone density and a 2.1% increase in hip bone density. In women on active treatment, the area under the receiver operator curve for a 6-month change in markers to predict a response in bone mineral density at 3 yr was highest for urine NTx (range, 75-78%) and lowest for osteocalcin (range, 60-66%). We conclude that short-term changes in biochemical markers of bone turnover at 6 months predict bone density changes at the spine and hip at 3 yr in elderly women on alendronate, hormone replacement therapy, or combination therapy.

Authors+Show Affiliations

Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pennsylvania 15213-3221, USA. griffithsd@msx.dept-med.pitt.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15713726

Citation

Greenspan, Susan L., et al. "Early Changes in Biochemical Markers of Bone Turnover Are Associated With Long-term Changes in Bone Mineral Density in Elderly Women On Alendronate, Hormone Replacement Therapy, or Combination Therapy: a Three-year, Double-blind, Placebo-controlled, Randomized Clinical Trial." The Journal of Clinical Endocrinology and Metabolism, vol. 90, no. 5, 2005, pp. 2762-7.
Greenspan SL, Resnick NM, Parker RA. Early changes in biochemical markers of bone turnover are associated with long-term changes in bone mineral density in elderly women on alendronate, hormone replacement therapy, or combination therapy: a three-year, double-blind, placebo-controlled, randomized clinical trial. J Clin Endocrinol Metab. 2005;90(5):2762-7.
Greenspan, S. L., Resnick, N. M., & Parker, R. A. (2005). Early changes in biochemical markers of bone turnover are associated with long-term changes in bone mineral density in elderly women on alendronate, hormone replacement therapy, or combination therapy: a three-year, double-blind, placebo-controlled, randomized clinical trial. The Journal of Clinical Endocrinology and Metabolism, 90(5), 2762-7.
Greenspan SL, Resnick NM, Parker RA. Early Changes in Biochemical Markers of Bone Turnover Are Associated With Long-term Changes in Bone Mineral Density in Elderly Women On Alendronate, Hormone Replacement Therapy, or Combination Therapy: a Three-year, Double-blind, Placebo-controlled, Randomized Clinical Trial. J Clin Endocrinol Metab. 2005;90(5):2762-7. PubMed PMID: 15713726.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early changes in biochemical markers of bone turnover are associated with long-term changes in bone mineral density in elderly women on alendronate, hormone replacement therapy, or combination therapy: a three-year, double-blind, placebo-controlled, randomized clinical trial. AU - Greenspan,Susan L, AU - Resnick,Neil M, AU - Parker,Robert A, Y1 - 2005/02/15/ PY - 2005/2/17/pubmed PY - 2005/6/10/medline PY - 2005/2/17/entrez SP - 2762 EP - 7 JF - The Journal of clinical endocrinology and metabolism JO - J Clin Endocrinol Metab VL - 90 IS - 5 N2 - Elderly women on combination therapy with alendronate and hormone replacement for osteoporosis have greater gains in bone mass than those on monotherapy. It is not known whether early changes in markers can predict the long-term changes in bone density with therapy. We assessed bone density and biochemical markers of bone turnover [urine N-telopeptide cross-linked collagen type 1 (NTx), serum bone-specific alkaline phosphatase, and osteocalcin] every 6 months for 3 yr in a double-blind, placebo-controlled, randomized clinical trial. After a 3-month run-in phase, 373 community-dwelling, elderly women were randomized to 1) alendronate, 2) hormone replacement therapy, 3) combination therapy with alendronate and hormone replacement therapy, or 4) placebo. Women on active treatment with the greatest decrease in markers of bone turnover at 6 months had the greatest increases in spine and hip bone density at 3 yr. The response to alendronate was generally associated with greater reductions in markers than the response to hormone replacement and was associated with greater increases in bone density at the spine and hip. Those in the tertile with the greatest decrease in urinary NTx had a 10.1% increase in spine bone density and a 6.1% increase in hip bone density compared with those in the lowest tertile, who had a 5.9% increase in spine bone density and a 2.1% increase in hip bone density. In women on active treatment, the area under the receiver operator curve for a 6-month change in markers to predict a response in bone mineral density at 3 yr was highest for urine NTx (range, 75-78%) and lowest for osteocalcin (range, 60-66%). We conclude that short-term changes in biochemical markers of bone turnover at 6 months predict bone density changes at the spine and hip at 3 yr in elderly women on alendronate, hormone replacement therapy, or combination therapy. SN - 0021-972X UR - https://www.unboundmedicine.com/medline/citation/15713726/Early_changes_in_biochemical_markers_of_bone_turnover_are_associated_with_long_term_changes_in_bone_mineral_density_in_elderly_women_on_alendronate_hormone_replacement_therapy_or_combination_therapy:_a_three_year_double_blind_placebo_controlled_randomized_clinical_trial_ L2 - https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2004-1091 DB - PRIME DP - Unbound Medicine ER -