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Effect of alendronate in elderly patients after low trauma hip fracture repair

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Abstract

Summary

One year of once weekly alendronate, when given shortly after the surgical repair of a hip fracture, produces reductions in bone markers and increases proximal femoral bone density. The therapy was well tolerated.

Introduction

Hip fracture is the most devastating type of osteoporotic fracture and increases notably the risk of subsequent fractures. The aim of this paper was to evaluate the effects of 1 year therapy with a weekly dose of alendronate in the bone mineral density and bone markers in elderly patients after low trauma hip fracture repair.

Methods

Two hundred thirty-nine patients (81 ± 7 years; 79.8% women) were randomized to be treated either with calcium (500 mg/daily) and vitamin D3 (400 IU/daily; Ca–Vit D group) or with alendronate (ALN, 70 mg/week) plus calcium and vitamin D3 (500 mg/daily and 400 IU/daily, respectively; ALN + Ca–Vit D group).

Results

One hundred forty-seven (61.5%) patients completed the trial. Alendronate increased proximal femoral bone mineral density (BMD) in the intention-to-treat analysis (mean difference (95% confidence interval); total hip 2.57% (0.67; 4.47); trochanteric 2.96% (0.71; 5.20), intertrochanteric 2.32% (0.36; 4.29)), but the differences were not significant in the BMD of the femoral neck (0.47%; (−2.03; 2.96) and the lumbar spine (0.69%; (−0.86; 2.23)). Bone turnover markers decreased during alendronate treatment.

Conclusion

The present study demonstrates for the first time the anti-resorptive efficacy of alendronate given immediately after surgical repair in an elderly population with recent hip fracture. This effect should positively affect the rate of subsequent fractures.

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References

  1. Melton LJ III (2000) Who has osteoporosis? A conflict between clinical and public health perspectives. J Bone Miner Res 15:2309–2314

    Article  PubMed  Google Scholar 

  2. Hannan EL, Magaziner J, Wang JJ, Eastwood EA, Silberzweig SB, Gilbert M, Morrison RS, McLaughlin MA, Orosz GM, Siu AL (2001) Mortality and locomotion 6 months after hospitalization for hip fracture: risk factors and risk-adjusted hospital outcomes. JAMA 285:2736–2742

    Article  PubMed  CAS  Google Scholar 

  3. Kane RL, Chen Q, Finch M, Blewett L, Burns R, Moskowitz M (1998) Functional outcomes of posthospital care for stroke and hip fracture patients under medicare. J Am Geriatr Soc 46:1525–1533

    PubMed  CAS  Google Scholar 

  4. Randell AG, Nguyen TV, Bhalerao N, Silverman SL, Sambrook PN, Eisman JA (2000) Deterioration in quality of life following hip fracture: a prospective study. Osteoporos Int 11:460–466

    Article  PubMed  CAS  Google Scholar 

  5. Brainsky A, Glick H, Lydick E, Epstein R, Fox KM, Hawkes W, Kashner TM, Zimmerman SI, Magaziner J (1997) The economic cost of hip fractures in community-dwelling older adults: a prospective study. J Am Geriatr Soc 45:281–287

    PubMed  CAS  Google Scholar 

  6. Bass E, French DD, Bradham DD, Rubenstein LZ (2007) Risk-adjusted mortality rates of elderly veterans with hip fractures. Ann Epidemiol 17:514–519

    Article  PubMed  Google Scholar 

  7. van Staa TP, Leufkens HG, Cooper C (2002) Does a fracture at one site predict later fractures at other sites? A British cohort study. Osteoporos Int 13:624–629

    Article  PubMed  Google Scholar 

  8. Colon-Emeric C, Kuchibhatla M, Pieper C, Hawkes W, Fredman L, Magaziner J, Zimmerman S, Lyles KW (2003) The contribution of hip fracture to risk of subsequent fractures: data from two longitudinal studies. Osteoporos Int 14:879–883

    Article  PubMed  Google Scholar 

  9. Lönnroos E, Kautiainen H, Karppi P, Hartikainen S, Kiviranta I, Sulkava R (2007) Incidence of second hip fractures. A population-based study. Osteoporos Int 18:1279–1285

    Article  PubMed  Google Scholar 

  10. Berry SD, Samelson EJ, Hannan MT, McLean RR, Lu M, Cupples LA, Shaffer ML, Beiser AL, Kelly-Hayes M, Kiel DP (2007) Second hip fracture in older men and women. The Framingham Study. Arch Intern Med 167:1971–1976

    Article  PubMed  Google Scholar 

  11. Karlsson M, Nilsson JA, Sernbo I, Redlund-Johnell I, Johnell O, Obrant KJ (1996) Changes of bone mineral mass and soft tissue composition after hip fracture. Bone 18:19–22

    Article  PubMed  CAS  Google Scholar 

  12. Kiebzak GM, Beinart GA, Perser K, Ambrose CG, Siff SJ, Heggeness MH (2002) Undertreatment of osteoporosis in men with hip fracture. Arch Intern Med 162:2217–2222

    Article  PubMed  Google Scholar 

  13. Hooven F, Gehlbach SH, Pekow P, Bertone E, Benjamin E (2005) Follow-up treatment for osteoporosis after fracture. Osteoporos Int 16:296–301

    Article  PubMed  Google Scholar 

  14. Davis JC, Ashe MC, Guy P, Khan KM (2006) Undertreatment after hip fracture: a retrospective study of osteoporosis overlooked. J Am Geriatr Soc 54:1019–1020

    Article  PubMed  Google Scholar 

  15. Moro Alvarez MJ, Díaz-Curiel M (2007) Pharmacological treatment of osteoporosis for people over 70. Aging Clin Exp Res 19:246–254

    PubMed  Google Scholar 

  16. Lyles KW, Colón-Emeric CS, Magaziner JS, Adachi JD, Pieper CF, Mautalen C, Hyldstrup L, Recknor C, Nordsletten L, Moore KA, Lavecchia C, Zhang J, Mesenbrink P, Hodgson PK, Abrams K, Orloff JJ, Horowitz Z, Eriksen EF, Boonen S, for the HORIZON Recurrent Fracture Trial (2007) Zoledronic acid and clinical fractures and mortality after hip fracture. N Engl J Med 357:1799–809

    Article  PubMed  CAS  Google Scholar 

  17. Diaz Curiel M, Carrasco de la Pena JL, Honorato Perez J, Perez Cano R, Rapado A, Ruiz Martinez I (1997) Study of bone mineral density in lumbar spine and femoral neck in a Spanish population. Multicentre Research Project on Osteoporosis. Osteoporosis Int 7:59–64

    Article  CAS  Google Scholar 

  18. Shane E, Tremaine WJ, Khosla S (2002) Bisphosphonates and the upper gastrointestinal tract: skeletal gain without visceral pain? Mayo Clin Proc 77:1029–1030

    Article  Google Scholar 

  19. Schnitzer T, Bone HG, Crepaldi G, Adami S, McClung M, Kiel D, Felsenberg D, Recker RR, Tonino RP, Roux C, Pinchera A, Foldes AJ, Greenspan SL, Levine MA, Emkey R, Santora AC 2nd, Kaur A, Thompson DE, Yates J, Orloff JJ (2000) Therapeutic equivalence of alendronate 70 mg once-weekly and alendronate 10 mg daily in the treatment of osteoporosis. Alendronate Once-Weekly Study Group. Aging (Milano) 12:1–12, Feb

    CAS  Google Scholar 

  20. Hans D, Downs RW Jr, Duboeuf F, Greenspan S, Jankowski LG, Kiebzak GM, Petak SM (2006) Skeletal sites for osteoporosis diagnosis: the 2005 ISCD official positions. J Clin Densitom 9:15–21

    Article  PubMed  Google Scholar 

  21. Magnusson HI, Lindén C, Obrant KJ, Johnell O, Karlsson MK (2001) Bone mass changes in weight-loaded and unloaded skeletal regions following a fracture of the hip. Calcif Tissue Int 69:78–83

    Article  PubMed  CAS  Google Scholar 

  22. Huybrechts KF, Ishak KJ, Caro JJ (2006) Assessment of compliance with osteoporosis treatment and its consequences in a managed care population. Bone 38:922–928

    Article  PubMed  Google Scholar 

  23. Siris ES, Harris ST, Rosen CJ, Barr CE, Arvesen JN, Abbott TA, Silverman S (2006) Adherence to bisphosphonate therapy and fracture rates in osteoporotic women: relationship to vertebral and nonvertebral fractures from 2 US claims databases. Mayo Clin Proc 81:1013–1022

    Article  PubMed  Google Scholar 

  24. Adami S, Isaia G, Luisetto G, Minisola S, Sinigaglia L, Gentilella R, Agnusdei D, Iori N, Nuti R, ICARO Study Group (2006) Fracture incidence and characterization in patients on osteoporosis treatment: the ICARO study. J Bone Miner Res 21:1565–1570

    Article  PubMed  CAS  Google Scholar 

  25. van Eijken M, Tsang S, Wensing M, de Smet PA, Grol RP (2003) Interventions to improve medication compliance in older patients living in the community: a systemic review of the literature. Drugs Aging 20:229–240

    Article  PubMed  Google Scholar 

  26. Roux C, Bischoff-Ferrari HA, Papapoulos SE, de Papp AE, West JA, Bouillon R (2008) New insights into the role of vitamin D and calcium in osteoporosis management: an expert roundtable discussion. Curr Med Res Opin 24:1363–1370

    Article  PubMed  CAS  Google Scholar 

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Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Traumatology and Orthopedic Surgery, University Hospital “12 de Octubre”, Avda de Andalucía km 5.4, Madrid, 28041, Spain

    D. Cecilia & C. Resines

  2. Endocrinology and Metabolism Services, University Hospital “12 de Octubre”, Avda de Andalucía km 5.4, Madrid, 28041, Spain

    E. Jódar & F. Hawkins

  3. Preventive Medicine Service, University Hospital “San Carlos”, Complutense University, Avda de Andalucía km 5.4, Madrid, 28041, Spain

    C. Fernández

  4. Servicio de Endocrinología y Nutrición, Hospital Universitario “12 de Octubre”, Avda Andalucía km 5.4, Madrid, 28041, Spain

    E. Jódar

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  1. D. Cecilia
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  2. E. Jódar
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  3. C. Fernández
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  4. C. Resines
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  5. F. Hawkins
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Corresponding author

Correspondence to E. Jódar.

Additional information

Funding Sources: This study was supported in part by a grant from “Asociación para la Investigación de Osteoporosis y Enfermedades Endocrinas” (AIOE) and from “Fundación Mutua Madrileña, Spain”.

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Cecilia, D., Jódar, E., Fernández, C. et al. Effect of alendronate in elderly patients after low trauma hip fracture repair. Osteoporos Int 20, 903–910 (2009). https://doi.org/10.1007/s00198-008-0767-z

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  • DOI: https://doi.org/10.1007/s00198-008-0767-z

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