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Abaloparatide followed by alendronate in women ≥80 years with osteoporosis: post hoc analysis of ACTIVExtend.
Menopause. 2020 10; 27(10):1137-1142.M

Abstract

OBJECTIVE

Fracture risk increases with age, but few studies focus on persons ≥80 years. In the ACTIVE trial, treatment with abaloparatide for 18 months reduced osteoporotic fracture risk and increased bone mineral density. These effects were maintained with 24 months alendronate treatment in ACTIVExtend. We postulated that similar improvements in bone mineral density and safety would be demonstrated in women ≥80 years.

METHODS

Post hoc analyses of bone mineral density and fracture incidence in women with osteoporosis at high risk of fracture ≥80 years from ACTIVExtend.

RESULTS

In total, 56 women aged ≥80 years at ACTIVE baseline entered the ACTIVExtend study; 46 of these completed the study. Mean age was 83.3 years; other baseline characteristics were similar. At the end of ACTIVE, bone mineral density increased at all sites for abaloparatide versus placebo. Bone mineral density increased in parallel in both groups during alendronate therapy (19 to 43 months) in ACTIVExtend. At month 43, mean percent change in bone mineral density from baseline was 17.2% abaloparatide/alendronate versus 8.6% placebo/alendronate (P < 0.0001) at the lumbar spine, 5.3% abaloparatide/alendronate versus 3.0% placebo/alendronate (P = 0.024) at the total hip, and 4.6% abaloparatide/alendronate versus 3.1% placebo/alendronate (P = 0.044) at the femoral neck. Fracture incidence was low and did not differ significantly between groups. Sequential treatment with abaloparatide followed by alendronate was well tolerated; the proportion of participants reporting adverse events was similar between groups.

CONCLUSIONS

Sequential treatment with abaloparatide followed by alendronate (43 months follow-up) in this small subgroup of ACTIVExtend participants suggests abaloparatide is well tolerated and effective in women aged ≥80 years. : Video Summary:http://links.lww.com/MENO/A618.

Authors+Show Affiliations

University of Pittsburgh, Pittsburgh, PA.Radius Health, Inc., Waltham, MA.Radius Health, Inc., Waltham, MA.Radius Health, Inc., Waltham, MA.MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.Cleveland Clinic, Cleveland, OH.Columbia University College of Physicians and Surgeons, New York, NY.Oregon Osteoporosis Center, Portland, OR. Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32665529

Citation

Greenspan, Susan L., et al. "Abaloparatide Followed By Alendronate in Women ≥80 Years With Osteoporosis: Post Hoc Analysis of ACTIVExtend." Menopause (New York, N.Y.), vol. 27, no. 10, 2020, pp. 1137-1142.
Greenspan SL, Fitzpatrick LA, Mitlak B, et al. Abaloparatide followed by alendronate in women ≥80 years with osteoporosis: post hoc analysis of ACTIVExtend. Menopause. 2020;27(10):1137-1142.
Greenspan, S. L., Fitzpatrick, L. A., Mitlak, B., Wang, Y., Harvey, N. C., Deal, C., Cosman, F., & McClung, M. (2020). Abaloparatide followed by alendronate in women ≥80 years with osteoporosis: post hoc analysis of ACTIVExtend. Menopause (New York, N.Y.), 27(10), 1137-1142. https://doi.org/10.1097/GME.0000000000001593
Greenspan SL, et al. Abaloparatide Followed By Alendronate in Women ≥80 Years With Osteoporosis: Post Hoc Analysis of ACTIVExtend. Menopause. 2020;27(10):1137-1142. PubMed PMID: 32665529.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Abaloparatide followed by alendronate in women ≥80 years with osteoporosis: post hoc analysis of ACTIVExtend. AU - Greenspan,Susan L, AU - Fitzpatrick,Lorraine A, AU - Mitlak,Bruce, AU - Wang,Yamei, AU - Harvey,Nicholas C, AU - Deal,Chad, AU - Cosman,Felicia, AU - McClung,Michael, PY - 2020/7/16/pubmed PY - 2021/4/28/medline PY - 2020/7/16/entrez SP - 1137 EP - 1142 JF - Menopause (New York, N.Y.) JO - Menopause VL - 27 IS - 10 N2 - OBJECTIVE: Fracture risk increases with age, but few studies focus on persons ≥80 years. In the ACTIVE trial, treatment with abaloparatide for 18 months reduced osteoporotic fracture risk and increased bone mineral density. These effects were maintained with 24 months alendronate treatment in ACTIVExtend. We postulated that similar improvements in bone mineral density and safety would be demonstrated in women ≥80 years. METHODS: Post hoc analyses of bone mineral density and fracture incidence in women with osteoporosis at high risk of fracture ≥80 years from ACTIVExtend. RESULTS: In total, 56 women aged ≥80 years at ACTIVE baseline entered the ACTIVExtend study; 46 of these completed the study. Mean age was 83.3 years; other baseline characteristics were similar. At the end of ACTIVE, bone mineral density increased at all sites for abaloparatide versus placebo. Bone mineral density increased in parallel in both groups during alendronate therapy (19 to 43 months) in ACTIVExtend. At month 43, mean percent change in bone mineral density from baseline was 17.2% abaloparatide/alendronate versus 8.6% placebo/alendronate (P < 0.0001) at the lumbar spine, 5.3% abaloparatide/alendronate versus 3.0% placebo/alendronate (P = 0.024) at the total hip, and 4.6% abaloparatide/alendronate versus 3.1% placebo/alendronate (P = 0.044) at the femoral neck. Fracture incidence was low and did not differ significantly between groups. Sequential treatment with abaloparatide followed by alendronate was well tolerated; the proportion of participants reporting adverse events was similar between groups. CONCLUSIONS: Sequential treatment with abaloparatide followed by alendronate (43 months follow-up) in this small subgroup of ACTIVExtend participants suggests abaloparatide is well tolerated and effective in women aged ≥80 years. : Video Summary:http://links.lww.com/MENO/A618. SN - 1530-0374 UR - https://www.unboundmedicine.com/medline/citation/32665529/Abaloparatide_followed_by_alendronate_in_women_≥80_years_with_osteoporosis:_post_hoc_analysis_of_ACTIVExtend_ L2 - https://doi.org/10.1097/GME.0000000000001593 DB - PRIME DP - Unbound Medicine ER -