Effects of Alendronate and Hormone Replacement Therapy, Alone or in Combination, on Bone Mass in Postmenopausal Women with Osteoporosis: A Prospective, Randomized Study

Effects of alendronate combined with hormone replacement therapy on osteoporotic postmenopausal Chinese women

“…Tiras et al [2] found that 10 mg alendronate combined with HRT produced significantly higher percentage increases in BMD at the L-spine than using HRT alone (8.4% vs 2.6%, respectively) after 12 months' treatment. A 2-year study indicated that the use of 10 mg alendronate daily plus estrogen produced greater increases (8.3%) in BMD at the lumber spine than using either agent alone [24].…”

“…Up to 1% to 3% of cortical bone and 5% of trabecular bone is lost per year after menopause [2]. Vertebral fractures occur in 25% of postmenopausal 0026-0495/$ -see front matter D 2006 Elsevier Inc. All rights reserved.…”

“…doi:10.1016/j.metabol.2006.01.008 women older than 70 years. The lifetime risk of hip fracture in women is 15%, which rises to 35% at the age of 90 years [2]. These fractures are associated with high rates (up to 20%) of morbidity and mortality [3,4].…”

Combination Osteoporosis Therapy with Parathyroid Hormone

“…The use of two antiresorptive agents together has been shown to have very limited additive effects on bone mass. [7][8][9][10][11][12][13][14][15][16][17] Thought to be a more promising approach, the combination of anabolic and antiresorptive agents held the theoretical potential to separate bone formation from resorption, allowing for either a more selective anabolic effect (no increase in bone resorption) or a more selective antiresorptive effect (preserved bone formation). Various animal models have been used to explore the effects of combined anabolic and antiresorptive agents, but have led to inconsistent and, sometimes, contradictory conclusions.…”

Combination/sequential therapy in osteoporosis

“…All biopsies had evidence of turnover in cortical bone, as shown by the presence of tetracycline label, but 10% of the biopsies issued from patients having received the combination did not show detectable cancellous label [24]. Alendronate (10 mg/day) has an additive effect to transdermal 17 βestradiol (50 µg twice a week) and medroxyprogesterone, when given to women with osteopenia [25] or to oral 17 βestradiol (2 mg/day) and norethisterone acetate (NETA), when given to women with spinal BMD T scores less than -2 [26]. In surgically PMW, treated with micronized (2 mg/day) estradiol, the addition of alendronate at a low dose (5 mg/daily) induced a gain of bone mass significantly greater, at the spine trochanter and femoral neck than estrogens alone but not significantly different, in comparison with that observed using a standard alendronate dose of 10 mg/day [27].…”