Modern Rheumatology

, Volume 23, Issue 3, pp 450–455

Clinical results of alendronate monotherapy and combined therapy with menatetrenone (VitK2) in postmenopausal RA patients

  • Kouji Suzuki
  • Shigeyoshi Tsuji
  • Yaeko Fukushima
  • Takanobu Nakase
  • Masayuki Hamada
  • Tetsuya Tomita
  • Hideki Yoshikawa
Original Article

DOI: 10.1007/s10165-012-0678-x

Cite this article as:
Suzuki, K., Tsuji, S., Fukushima, Y. et al. Mod Rheumatol (2013) 23: 450. doi:10.1007/s10165-012-0678-x

Abstract

Objectives

We aimed to evaluate the clinical efficacy of monotherapy with alendronate and combined therapy with alendronate and menatetrenone (vitamin K2 [VitK2]) in postmenopausal rheumatoid arthritis (RA) patients with osteoporosis or osteopenia.

Methods

Sixty-two postmenopausal RA patients with untreated osteoporosis or osteopenia (lumbar spine bone density ≤80 % of young adult mean [YAM]) were enrolled: 39 had abnormal serum undercarboxylated osteocalcin (ucOC) levels (>4.5 ng/mL) and received combined therapy with alendronate (35 mg/week) and VitK2 (45 mg/day) (ALN + K group); 23 had normal ucOC levels (≤4.5 ng/mL) and received alendronate monotherapy (35 mg/week) (ALN group). The clinical results for the 57 patients in both groups were evaluated after 1-year treatment.

Results

The mean baseline/follow-up (FU) lumbar spine bone density (%YAM) values were 73.0/76.8 % (P < 0.01) in the ALN + K group and 77.0/80.3 % (P < 0.01) in the ALN group; a significant increase was shown in both groups. Mean proximal femoral bone density values at baseline/FU were 71.4/73.8 (P < 0.01) in the ALN + K group and 71.4/71.6 % (not significant; NS) in the ALN group; a significant increase was shown in the ALN + K group only. Serum ucOC levels were normalized in the ALN + K group at FU. At FU, bone metabolism markers [bone-specific alkaline phosphatase (BAP) and N-terminal cross-linked telopeptides of type I collagen] were decreased in both groups. One patient in the ALN + K group and three in the ALN group suffered new fractures.

Conclusions

Combined therapy with alendronate and VitK2 decreases bone metabolism marker levels and serum ucOC levels, and increases lumbar spine and femoral neck bone density in postmenopausal RA patients with abnormal ucOC levels and osteoporosis or osteopenia.

Keywords

Undercarboxylated osteocalcin (ucOC) Rheumatoid arthritis (RA) Menatetrenone (VitK2Alendronate (ALN) Osteoporosis 

Copyright information

© Japan College of Rheumatology 2012

Authors and Affiliations

  • Kouji Suzuki
    • 1
  • Shigeyoshi Tsuji
    • 1
  • Yaeko Fukushima
    • 2
  • Takanobu Nakase
    • 1
  • Masayuki Hamada
    • 1
  • Tetsuya Tomita
    • 3
  • Hideki Yoshikawa
    • 3
  1. 1.Department of Orthopaedic SurgeryHoshigaoka Koseinenkin HospitalHirakataJapan
  2. 2.Osaka Trauma and Microsurgery Center, Seikeikai HospitalSakaiJapan
  3. 3.Department of OrthopaedicsOsaka University Graduate School of MedicineSuitaJapan