Alendronate Prevents Loss of Bone Density Associated With Discontinuation of Hormone Replacement Therapy

Ascott-Evans, Brynne; Guañabens, Núria; Kivinen, Seppo; Stuckey, Bronwyn; Magaril, C.; Vandormael, K.; Stych, B.; Melton, Mary E.

doi:10.1001/archinte.163.7.789

Cited by 67 publications

(40 citation statements)

References 41 publications

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“…Low potency hormone replacement does not, however, appear to reduce hip fracture risk [32]. Discontinuation of hormone therapy results in prompt increases in bone turnover [33], substantial decreases in BMD [33], and loss of mechanical strength in the femur [34]. In addition, an increased risk for hip fracture, relative to women who have never used hormones, has been reported for women who have recently (within 5 years) stopped taking hormones [35].…”

Section: Estrogen Exposuresmentioning

confidence: 99%

Hip fracture: Risk factors and outcomes

Wehren

Magaziner

2003

Curr Osteoporos Rep

106

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Hip fracture is an important public health and personal burden, and this burden is anticipated to increase over the next several decades. Although white women experience the greatest lifetime risk of hip fracture, risk extends to men and to nonwhite populations. Bone strength, risk of falling, and individual clinical characteristics combine to affect the risk of hip fracture. Nearly $9 billion were expended in 1995 in the United States for the management of hip fractures. Hip fracture has important sequelae, including loss of bone and muscle mass. Mortality is significantly increased after hip fracture, and functional recovery is limited to less than 50% of those who fracture. About 25% of patients reside in long-term care facilities for a year or more after fracture, and the impact of hip fracture on health-related quality of life is considerable and long lasting.

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Section: Estrogen Exposuresmentioning

confidence: 99%

Hip fracture: Risk factors and outcomes

Wehren

Magaziner

2003

Curr Osteoporos Rep

106

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“…In the group originally treated with ALN 10 mg daily for 5 years, subsequent switch-over to placebo led to gradual declines in bone mineral density (BMD) and increases in turnover after ALN was stopped. In contrast, rapid bone loss and large increases in turnover were seen after stopping hormone therapy in other trials 36,37 . To date, effects of discontinuation of other BPs on BMD and turnover have not been published.…”

Section: Bp Retention In Bonementioning

confidence: 90%

Bone safety of long-term bisphosphonate treatment

Rodan

Reszka

Golub

et al. 2004

Current Medical Research and Opinion

112

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Bisphosphonates (BPs) are widely used in osteoporosis and other bone diseases. Treatment of osteoporosis would, in many instances, involve continued use of BP for a number of years, so it is pertinent to examine skeletal consequences of long-term BP use. Through a non-systematic review of the literature, this commentary considers the reduction in bone turnover and retention in the skeleton with regard to the long-term safety of BP use. BPs normalize bone turnover rates within weeks and no further suppression is seen during long term use, documented up to 10 years. This indicates that the BP retained in bone does not augment or contribute to the pharmacological activity of newly administered BP. Therefore, pharmacologically, long term treatment is not different from short term treatment. Multiple studies have shown that reductions in bone turnover are associated with increased bone density, more homogeneous mineralization, and reduced fracture risk. The amount of BP retained in bone after 10 years of alendronate treatment was estimated at 75 mg per 2 kg mineral, using a pharmacokinetic model for a dose of 10 mg per day. This small fraction, which is unevenly distributed between cancellous and cortical bone, seems unlikely to change bone mechanical properties. Taken together, the known mechanism of action of potent BPs and the experience accrued from treating a large number of patients, including up to 10 years follow-up in controlled trials, have identified only beneficial BP effects on bone.

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“…Treatment with 10 mg/d prevented bone loss in women who discontinued estrogen therapy [26]. In men with low BMD (T score -2 or lower) treated with 10 mg/d for 2 years, bone density in the spine and hip increased, and vertebral fracture rates decreased [27].…”

Section: Alendronatementioning

confidence: 98%

Use of highly potent bisphosphonates in the treatment of osteoporosis

McClung

2003

Curr Osteoporos Rep

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Bisphosphonates are effective inhibitors of bone remodeling. In the clinical setting, these agents prevent bone loss, preserve bone architecture, and improve bone strength. Clinically significant reduction in the risk of spine and nonspine fractures is observed in patients known to be at risk for fracture. When administered appropriately, these drugs are well tolerated and have an excellent safety profile. Potent bisphosphonates are now the preferred treatment option to reduce the fracture risk in men and women with involutional and glucocorticoid-induced osteoporosis.

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Alendronate Prevents Loss of Bone Density Associated With Discontinuation of Hormone Replacement Therapy

Cited by 67 publications

References 41 publications

Hip fracture: Risk factors and outcomes

Hip fracture: Risk factors and outcomes

Bone safety of long-term bisphosphonate treatment

Use of highly potent bisphosphonates in the treatment of osteoporosis

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