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Clinical Rheumatology

, Volume 32, Issue 12, pp 1759–1766 | Cite as

Alendronate treatment for hip osteoarthritis: prospective randomized 2-year trial

  • Takashi NishiiEmail author
  • Satoru Tamura
  • Toshiyuki Shiomi
  • Hideki Yoshikawa
  • Nobuhiko Sugano
Original Article

Abstract

We examined the clinical efficacy of alendronate treatment for hip osteoarthritis using multiple outcome measures. Fifty patients with symptomatic hip osteoarthritis were enrolled in this prospective trial. The patients were randomly assigned to an alendronate group (35 mg/week alendronate and 600 mg/day calcium lactate) or a control group (600 mg/day calcium lactate) for 2 years. The groups were compared with regard to the following five parameters. The primary outcome measures are the following: (1) the Western Ontario and McMaster Universities (WOMAC) osteoarthritis pain score and the visual analog score (VAS). The secondary outcome measures are the following: (2) joint space width (JSW) measured on radiographs using a semiautomatic computer software, (3) the biochemical markers urinary N-telopeptide of type I collagen (NTX-I) and C-terminal cross-linking telopeptide of type II collagen (CTX-II), (4) dual-energy X-ray absorptiometry of the hip and lumbar spine, and (5) bone marrow edema on magnetic resonance images. The alendronate group showed pain improvement trends in VAS and WOMAC scores, whereas the control group showed worsening of pain. The alendronate group showed significant improvement in WOMAC pain scores after 12 months (p = 0.031) but no significant prevention of structural osteoarthritis progression, defined as a decrease in JSW >0.30 mm or conversion to total hip arthroplasty. There was significantly larger decrease in the biochemical markers and significantly increased bone density in the alendronate group. Alendronate treatment by standard dose for osteoporosis showed clinical efficacy for decreasing pain but failed to show preventive effects for structural progression of hip osteoarthritis.

Keywords

Alendronate Hip osteoarthritis Randomized controlled trial Structure-modifying effects Symptom-modifying effects 

Notes

Acknowledgements

We gratefully acknowledge Hidenobu Miki, Katsuya Nakata, Mitsuyoshi Yamamura, Shyunsaku Nishihara, and Kengo Yamamoto in the Osaka Osteoarthritis Forum group for their instructions of establishment in study design and analysis of the study outcomes. Part of this study was funded by Grant from Osaka Foundation for the Prevention of Cancer and Cardiovascular Disease and Grant-in-Aid for Scientific Research, the Ministry of Education, Science and Culture of Japan.

Disclosures

None.

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Copyright information

© Clinical Rheumatology 2013

Authors and Affiliations

  • Takashi Nishii
    • 1
    Email author
  • Satoru Tamura
    • 1
  • Toshiyuki Shiomi
    • 1
  • Hideki Yoshikawa
    • 2
  • Nobuhiko Sugano
    • 1
  1. 1.Department of Orthopaedic Medical EngineeringOsaka University Graduate School of MedicineSuita, OsakaJapan
  2. 2.Department of Orthopaedic SurgeryOsaka University Graduate School of Medicine, 2–2 YamadaokaSuita, OsakaJapan

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