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Effect of alendronate on the age-specific incidence of symptomatic osteoporotic fractures.
J Bone Miner Res. 2005 Jun; 20(6):971-6.JB

Abstract

Analyses of data from 3658 postmenopausal women with osteoporosis enrolled in the Fracture Intervention Trial showed that alendronate is effective in reducing the risk of symptomatic osteoporotic fractures across a spectrum of ages.

INTRODUCTION

Most osteoporosis studies examine the relative risk of fracture based on the entire duration of treatment. Because older patients tend to be at higher risk for osteoporosis-related fractures, this analysis examined the effect of alendronate treatment on the relative risk of fracture in terms of the age that patients attained during the study.

MATERIALS AND METHODS

We studied 3658 postmenopausal women with osteoporosis 55-80 years of age at baseline enrolled in the Fracture Intervention Trial, a large randomized, double-blind, placebo-controlled study. Patients were treated with placebo or with alendronate at a daily dose of 5 mg for 2 years followed by 10 mg for an additional 1-2.5 years, and monitored for clinical fractures. Age, rather than study time, was the dynamic variable in our analysis.

RESULTS

The relative risk reductions for hip, clinical spine, and wrist fractures were constant across age groups, without evidence of a decline at older ages. Specifically, alendronate reduced the risk of clinical fracture by 53% at the hip (relative risk [RR] = 0.47; 95% CI = 0.27-0.81; p < 0.01), 45% at the spine (RR = 0.55; 95% CI = 0.37-0.83; p < 0.01), and 31% at the wrist (RR = 0.69; 95% CI = 0.50-0.98; p = 0.038). In addition, alendronate produced a significant risk reduction of 40% (RR = 0.60; 95% CI = 0.47-0.77; p < 0.01) for the composite event of clinical hip, spine, and wrist fractures. As a consequence of the constant relative risk model, the absolute risk reduction with alendronate treatment increased with age because of the age-related increase in fracture risk in the placebo group. The absolute risk reduction for the composite event (hip, spine, and wrist fractures together) for alendronate treatment versus placebo was 65, 80, 111, and 161 women with fractures per 10,000 PYR for the 55 to <65, 65 to <70, 70 to <75, and 75-85 year age groups, respectively.

CONCLUSIONS

These data show that alendronate is effective in reducing the risk of symptomatic osteoporotic fractures across a spectrum of ages. The effectiveness is somewhat greater in patients with femoral neck T score < or = -2.5 than in those with a T score < or = -2.0.

Authors+Show Affiliations

University of Maryland School of Medicine, Baltimore, Maryland, USA. mhochber@umaryland.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

15883637

Citation

Hochberg, Marc C., et al. "Effect of Alendronate On the Age-specific Incidence of Symptomatic Osteoporotic Fractures." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 20, no. 6, 2005, pp. 971-6.
Hochberg MC, Thompson DE, Black DM, et al. Effect of alendronate on the age-specific incidence of symptomatic osteoporotic fractures. J Bone Miner Res. 2005;20(6):971-6.
Hochberg, M. C., Thompson, D. E., Black, D. M., Quandt, S. A., Cauley, J., Geusens, P., Ross, P. D., & Baran, D. (2005). Effect of alendronate on the age-specific incidence of symptomatic osteoporotic fractures. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 20(6), 971-6.
Hochberg MC, et al. Effect of Alendronate On the Age-specific Incidence of Symptomatic Osteoporotic Fractures. J Bone Miner Res. 2005;20(6):971-6. PubMed PMID: 15883637.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of alendronate on the age-specific incidence of symptomatic osteoporotic fractures. AU - Hochberg,Marc C, AU - Thompson,Desmond E, AU - Black,Dennis M, AU - Quandt,Sara A, AU - Cauley,Jane, AU - Geusens,Piet, AU - Ross,Philip D, AU - Baran,Dan, AU - ,, Y1 - 2005/01/18/ PY - 2003/11/01/received PY - 2004/11/17/revised PY - 2005/01/11/accepted PY - 2005/5/11/pubmed PY - 2005/10/4/medline PY - 2005/5/11/entrez SP - 971 EP - 6 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 - 20 IS - 6 N2 - UNLABELLED: Analyses of data from 3658 postmenopausal women with osteoporosis enrolled in the Fracture Intervention Trial showed that alendronate is effective in reducing the risk of symptomatic osteoporotic fractures across a spectrum of ages. INTRODUCTION: Most osteoporosis studies examine the relative risk of fracture based on the entire duration of treatment. Because older patients tend to be at higher risk for osteoporosis-related fractures, this analysis examined the effect of alendronate treatment on the relative risk of fracture in terms of the age that patients attained during the study. MATERIALS AND METHODS: We studied 3658 postmenopausal women with osteoporosis 55-80 years of age at baseline enrolled in the Fracture Intervention Trial, a large randomized, double-blind, placebo-controlled study. Patients were treated with placebo or with alendronate at a daily dose of 5 mg for 2 years followed by 10 mg for an additional 1-2.5 years, and monitored for clinical fractures. Age, rather than study time, was the dynamic variable in our analysis. RESULTS: The relative risk reductions for hip, clinical spine, and wrist fractures were constant across age groups, without evidence of a decline at older ages. Specifically, alendronate reduced the risk of clinical fracture by 53% at the hip (relative risk [RR] = 0.47; 95% CI = 0.27-0.81; p < 0.01), 45% at the spine (RR = 0.55; 95% CI = 0.37-0.83; p < 0.01), and 31% at the wrist (RR = 0.69; 95% CI = 0.50-0.98; p = 0.038). In addition, alendronate produced a significant risk reduction of 40% (RR = 0.60; 95% CI = 0.47-0.77; p < 0.01) for the composite event of clinical hip, spine, and wrist fractures. As a consequence of the constant relative risk model, the absolute risk reduction with alendronate treatment increased with age because of the age-related increase in fracture risk in the placebo group. The absolute risk reduction for the composite event (hip, spine, and wrist fractures together) for alendronate treatment versus placebo was 65, 80, 111, and 161 women with fractures per 10,000 PYR for the 55 to <65, 65 to <70, 70 to <75, and 75-85 year age groups, respectively. CONCLUSIONS: These data show that alendronate is effective in reducing the risk of symptomatic osteoporotic fractures across a spectrum of ages. The effectiveness is somewhat greater in patients with femoral neck T score < or = -2.5 than in those with a T score < or = -2.0. SN - 0884-0431 UR - https://www.unboundmedicine.com/medline/citation/15883637/Effect_of_alendronate_on_the_age_specific_incidence_of_symptomatic_osteoporotic_fractures_ DB - PRIME DP - Unbound Medicine ER -