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Pharmacy World and Science

, Volume 27, Issue 3, pp 149–153 | Cite as

Effects of Alendronate and Calcitonin on Bone Mineral Density in Postmenopausal Osteoporotic Women. An Observational Study

  • Miroslava HejdovaEmail author
  • Vladimir Palicka
  • Zdenek Kucera
  • Jiri Vlcek
Article

Abstract

Objective: Alendronate and calcitonin are antiresorptive drugs that were used for the treatment of postmenopausal osteoporosis and were shown to increase bone mineral density (BMD). However, the effect of both drugs in daily clinical practice may differ from that observed in clinical trials.

Method: About 50 postmenopausal osteoporotic women were observed during their first year of treatment. Among them, 32 patients used alendronate and 18 used calcitonin. Lumbar spine and femoral neck BMD were measured by dual energy X-ray absorptiometry (DXA) at baseline and after 1 year of therapy. Biochemical markers (B-ALP – bone-specific alkaline phosphatase, OTC – osteocalcin and DPD/UCr – deoxypyridinoline/creatinine ratio) of bone metabolism were measured at baseline and 6 months later. Patient compliance was assumed by tablet counting and verified at interview. Each patient was further questioned about her attitude towards the treatment, as well as her dairy product intake, physical activity, use of other medications, smoking and social status.

Main outcome measure: (1) Annual percent change in BMD in lumbar spine and femoral neck after the one-year treatment with either alendronate or calcitonin. (2) The change in biochemical markers of bone turnover.

Results: The lumbar spine BMD significantly increased by 7.0% (P < 0.001), the femoral neck BMD by 4.3% (P < 0.01). OTC, B-ALP and DPD/UCr decreased significantly during the therapy with alendronate. Compliance with therapy was 79% (95% CI 68–90%). In the calcitonin-treated group, the lumbar spine BMD significantly increased by 3.1 % (P < 0.05), while the femoral neck BMD remained unchanged. OTC, B-ALP and DPD/UCr did not change significantly during the treatment with calcitonin. Compliance with calcitonin therapy was 87% (95% CI 63–110%). The annual change of BMD in both treatment groups was independent on all questioned factors.

Conclusion: In daily practice, alendronate enhanced significantly BMD both in lumbar spine and femoral neck. Calcitonin showed increase only in the lumbar spine BMD.

Keywords

Alendronate Bone mineral density Calcitonin Czech Republic Observational study Postmenopausal osteoporosis 

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References

  1. NIH Consensus Statement.2000Osteoporosis Prevention, Diagnosis, and TherapyMarch 27–29.17136Google Scholar
  2. Chesnut, CH, Silverman, S, Andriano, K, Genant, H, Gimona, A, Harris, S,  et al. 2000A randomized trial of nasal spray salmon calcitonin in postmenopausal women with established osteoporosis: the prevent recurrence of osteoporotic fractures studyAm J Med10926776PubMedGoogle Scholar
  3. Wasnich, RD, Miller, PD. 2000Antifracture efficacy of antiresorptive treatments are related to changes in bone mineral densityJ Clin Endocrinol Metab852316PubMedGoogle Scholar
  4. Hochberg, M, Ross, PD, Black, D,  et al. 1999Larger increase in bone mineral density during alendronate therapy are associated with a lower risk of new vertebral fractures in women with postmenopausal osteoporosisArthritis Rheum4212464CrossRefPubMedGoogle Scholar
  5. Marshall, D, Johnell, O, Wedel, H. 1996Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fracturesBMJ31212549PubMedGoogle Scholar
  6. Meunier, PJ, Boivin, G. 1997Bone mineral density reflects bone mass but also the degree of mineralization of bone: therapeutic implicationsBone213737PubMedGoogle Scholar
  7. Bone, GH, Greenspan, SL, McKeever, C, Bell, N, Davidson, M, Downs, RW,  et al. 2000Alendronate and estrogen effects in postmenopausal women with low bone mineral densityJ Clin Endocrinol Metab857206CrossRefPubMedGoogle Scholar
  8. Johnell, O, Scheele, WH, Lu, Y, Reginster, JY, Need, AG, Seeman, E. 2002Additive effect of raloxifene and alendronate on bone density and biochemical markers of bone remodeling in postmenopausal women with osteoporosisJ Clin Endocrinol Metab8798592CrossRefPubMedGoogle Scholar
  9. Tonino, RP, Meunier, PJ, Emkey, R, Rodriguez-Portales, JA, Menkens, CA, Wasnich, RD. 2000Skeletal benefits of alendronate: 7-year treatment of postmenopausal osteoporotic womenJ Clin Endocrinol Metab85310915CrossRefPubMedGoogle Scholar
  10. Fairney, A, Kyd, P, Thomas, E, Wilson, J. 2000Response to alendronate in osteoporosis after previous treatment with etidronateOsteoporos Int116215CrossRefPubMedGoogle Scholar
  11. Pols, HAP, Felsenberg, D, Hanley, DA, Stepan, J, Munoz-Torres, M, Wilkin, TJ,  et al. 1999Multinational, placebo-controlled, randomized trial of the effects of alendronate on bone density and fracture risk in postmenopausal women with low bone mass: results of the FOSIT studyOsteoporos Int94618PubMedGoogle Scholar
  12. Devogelaer, JP, Broll, H, Correa-Rotter, R, Cumming, DC, De Deuxchaisnes, CN, Geusens, P,  et al. 1996Oral alendronate induces progressive increases in bone mass of the spine, hip and total body over 3 years in postmenopausal women with osteoporosisBone1814150CrossRefPubMedGoogle Scholar
  13. Body, JJ, Gregory, AG, Scheele, WH, Kulkarni, PM, Miller, PD, Peretz, A,  et al. 2002A randomized double-blind trial to compare the efficacy of teriparatide (recombinant human parathyroid hormone (1–34)) with alendronate in postmenopausal women with osteoporosisJ Clin Endocrinol Metab87452835PubMedGoogle Scholar
  14. Murphy, MG, Weiss, S, McClung, M, Schnitzer, T, Cerchio, K, Connor, J,  et al. 2001Effect of alendronate and MK-667 (a growth hormone secretagogue), individually and in combination, on markers of bone turnover and bone mineral density in postmenopausal osteoporotic womenJ Clin Endocrinol Metab86111625CrossRefPubMedGoogle Scholar
  15. Downs, RW, Bell, NH, Ettinger, MP, Walsh, BW, Favus, MJ, Mako, B,  et al. 2000Comparison of alendronate and intranasal calcitonin for treatment of osteoporosis in postmenopausal womenJ Clin Endocrinol Metab8517838CrossRefPubMedGoogle Scholar
  16. Thamsborg, G, Jensen, JE, Kollerup, G, Hauge, EM, Melsen, F, Sorensen, OH. 1996Effect of nasal salmon calcitonin on bone remodeling and bone mass in postmenopausal osteoporosisBone1820712CrossRefPubMedGoogle Scholar
  17. Ellerington, MC, Hillard, TC, Whitcroft, SI, Marsh, MS, Lees, B, Banks, LM,  et al. 1996Intranasal salmon calcitonin for the prevention and treatment of postmenopausal osteoporosisCalcif Tissue Int59611CrossRefPubMedGoogle Scholar
  18. Reginster, JY, Deroisy, R, Lecart, MP, Sarlet, N, Zegels, B, Jupsin, I,  et al. 1995A double-blind, placebo-controlled, dose-finding trial of intermittent nasal salmon calcitonin for prevention of postmenopausal lumbar spine bone lossAm J Med984528CrossRefPubMedGoogle Scholar
  19. Overgaard, K. 1994Effect of intranasal salmon calcitonin therapy on bone mass and bone turnover in early postmenopausal women: a dose-response studyCalcif Tissue Int55826CrossRefPubMedGoogle Scholar
  20. Adami S, Baroni MC, Broggini M, Carratelli L, Caruso I, Gnessi L et al. (1993). Treatment of postmenopausal osteoporosis with continuous daily oral alendronate in comparison with either placebo or intranasal salmon calcitonin. Osteoporos Int (Suppl 3): S21–S27Google Scholar
  21. Kapetanos G, Symeonides PP, Dimitriou C, Karakatsanis K, Potoupnis M. (1997). A double blind study of intranasal calcitonin for established postmenopausal osteoporosis. Acta Orthop Scand (Suppl 275): 108–11Google Scholar
  22. Overgaard, K, Lindsay, R, Christiansen, C. 1995Patient responsiveness to calcitonin salmon nasal spray: a subanalysis of a 2-year studyClin Ther55826Google Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • Miroslava Hejdova
    • 1
    Email author
  • Vladimir Palicka
    • 2
  • Zdenek Kucera
    • 1
  • Jiri Vlcek
    • 1
  1. 1.Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec KraloveCharles University in PragueHradec KraloveCzech Republic
  2. 2.Osteocentre, University HospitalCharles UniversityHradec KraloveCzech Republic

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