Hip fracture protection by alendronate treatment in postmenopausal women with osteoporosis: a review of the literature

Jun Iwamoto1, Yoshihiro Sato2, Tsuyoshi Takeda1, Hideo Matsumoto21Department of Sports Medicine, Keio University School of Medicine, Tokyo, Japan; 2Department of Neurology, Mitate Hospital, Fukuoka, JapanAbstract: Osteoporosis most commonly affects postmenopausal women, placing them at a significant...

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Autores principales: Jun Iwamoto, Yoshihiro Sato, Tsuyoshi Takeda, Hideo Matsumoto
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Lenguaje:EN
Publicado: Dove Medical Press 2008
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spelling oai:doaj.org-article:f131d1b118c042ae982f98a99b3a03ae2021-12-02T03:48:17ZHip fracture protection by alendronate treatment in postmenopausal women with osteoporosis: a review of the literature1178-1998https://doaj.org/article/f131d1b118c042ae982f98a99b3a03ae2008-09-01T00:00:00Zhttps://www.dovepress.com/hip-fracture-protection-by-alendronate-treatment-in-postmenopausal-wom-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Jun Iwamoto1, Yoshihiro Sato2, Tsuyoshi Takeda1, Hideo Matsumoto21Department of Sports Medicine, Keio University School of Medicine, Tokyo, Japan; 2Department of Neurology, Mitate Hospital, Fukuoka, JapanAbstract: Osteoporosis most commonly affects postmenopausal women, placing them at a significant risk of fractures. In particular, hip fractures are an important cause of mortality and morbidity among postmenopausal women. Anti-resorptive therapies that produce greater decreases in bone turnover markers together with greater increases in bone mineral density (BMD) are associated with greater reductions in fracture risk, especially at sites primarily composed of cortical bone such as the hip. Thus, treatment with potent anti-resorptive drugs like alendronate is a strategy for preventing hip fractures in postmenopausal women with osteoporosis. The purpose of this paper is to discuss the efficacy of alendronate against hip fractures and the mechanism for this anti-fracture efficacy in postmenopausal women with osteoporosis. A meta-analysis of randomized controlled trials has shown that alendronate reduces the risk of hip fractures by 55% in postmenopausal women with osteoporosis. According to the analyses of the Fracture Intervention Trial, each 1 standard deviation reduction in a 1-year change in bone-specific alkaline phosphatase (BSAP) is associated with 39% fewer hip fractures in alendronate-treated postmenopausal women, and those with at least 30% reduction in BSAP have a 74% lower risk of hip fractures relative to those with less than 30%. Alendronate is effective in reducing the risk of hip fractures across a spectrum of ages. The mechanism for this anti-fracture efficacy has been clarified; alendronate strongly suppresses bone turnover and subsequently increases hip BMD, decreases cortical porosity, improves parameters of hip structure geometry (cortical thickness, cross-sectional area, section modulus, and buckling ratio), and produces more uniform mineralization (increases the mean degree of mineralization of bone) in cortical bone. A once-weekly regimen of alendronate administration provides better patient compliance and persistence with the treatment than the once-daily dosing regimen, leading to greater efficacy against hip fractures. Thus, the efficacy of alendronate against hip fractures has been confirmed in postmenopausal women with osteoporosis, especially with a once-weekly dosing regimen.Keywords: hip fracture, bone turnover, bone mineral density, cortical porosity, cortical thicknessJun IwamotoYoshihiro SatoTsuyoshi TakedaHideo MatsumotoDove Medical PressarticleHip fractureBone turnoverBone mineral density (BMD)Cortical PorosityCortical thicknessGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 3, Pp 483-489 (2008)
institution DOAJ
collection DOAJ
language EN
topic Hip fracture
Bone turnover
Bone mineral density (BMD)
Cortical Porosity
Cortical thickness
Geriatrics
RC952-954.6
spellingShingle Hip fracture
Bone turnover
Bone mineral density (BMD)
Cortical Porosity
Cortical thickness
Geriatrics
RC952-954.6
Jun Iwamoto
Yoshihiro Sato
Tsuyoshi Takeda
Hideo Matsumoto
Hip fracture protection by alendronate treatment in postmenopausal women with osteoporosis: a review of the literature
description Jun Iwamoto1, Yoshihiro Sato2, Tsuyoshi Takeda1, Hideo Matsumoto21Department of Sports Medicine, Keio University School of Medicine, Tokyo, Japan; 2Department of Neurology, Mitate Hospital, Fukuoka, JapanAbstract: Osteoporosis most commonly affects postmenopausal women, placing them at a significant risk of fractures. In particular, hip fractures are an important cause of mortality and morbidity among postmenopausal women. Anti-resorptive therapies that produce greater decreases in bone turnover markers together with greater increases in bone mineral density (BMD) are associated with greater reductions in fracture risk, especially at sites primarily composed of cortical bone such as the hip. Thus, treatment with potent anti-resorptive drugs like alendronate is a strategy for preventing hip fractures in postmenopausal women with osteoporosis. The purpose of this paper is to discuss the efficacy of alendronate against hip fractures and the mechanism for this anti-fracture efficacy in postmenopausal women with osteoporosis. A meta-analysis of randomized controlled trials has shown that alendronate reduces the risk of hip fractures by 55% in postmenopausal women with osteoporosis. According to the analyses of the Fracture Intervention Trial, each 1 standard deviation reduction in a 1-year change in bone-specific alkaline phosphatase (BSAP) is associated with 39% fewer hip fractures in alendronate-treated postmenopausal women, and those with at least 30% reduction in BSAP have a 74% lower risk of hip fractures relative to those with less than 30%. Alendronate is effective in reducing the risk of hip fractures across a spectrum of ages. The mechanism for this anti-fracture efficacy has been clarified; alendronate strongly suppresses bone turnover and subsequently increases hip BMD, decreases cortical porosity, improves parameters of hip structure geometry (cortical thickness, cross-sectional area, section modulus, and buckling ratio), and produces more uniform mineralization (increases the mean degree of mineralization of bone) in cortical bone. A once-weekly regimen of alendronate administration provides better patient compliance and persistence with the treatment than the once-daily dosing regimen, leading to greater efficacy against hip fractures. Thus, the efficacy of alendronate against hip fractures has been confirmed in postmenopausal women with osteoporosis, especially with a once-weekly dosing regimen.Keywords: hip fracture, bone turnover, bone mineral density, cortical porosity, cortical thickness
format article
author Jun Iwamoto
Yoshihiro Sato
Tsuyoshi Takeda
Hideo Matsumoto
author_facet Jun Iwamoto
Yoshihiro Sato
Tsuyoshi Takeda
Hideo Matsumoto
author_sort Jun Iwamoto
title Hip fracture protection by alendronate treatment in postmenopausal women with osteoporosis: a review of the literature
title_short Hip fracture protection by alendronate treatment in postmenopausal women with osteoporosis: a review of the literature
title_full Hip fracture protection by alendronate treatment in postmenopausal women with osteoporosis: a review of the literature
title_fullStr Hip fracture protection by alendronate treatment in postmenopausal women with osteoporosis: a review of the literature
title_full_unstemmed Hip fracture protection by alendronate treatment in postmenopausal women with osteoporosis: a review of the literature
title_sort hip fracture protection by alendronate treatment in postmenopausal women with osteoporosis: a review of the literature
publisher Dove Medical Press
publishDate 2008
url https://doaj.org/article/f131d1b118c042ae982f98a99b3a03ae
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