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1st
appeared 23 December 1998
Study Shows Drug Reduces Risk of Spine and Hip Fractures in
Women with Osteoporosis
A drug for the treatment of osteoporosis dramatically reduced the risk of spine and hip
fractures by almost half and the risk of other painful fractures by 30 percent among women
with osteoporosis, according to a study by UCSF researchers.
The drug, called alendronate, is a bisphosphonate that binds to bones and protects against
bone loss. During a four-year study of 4432 postmenopausal women, 2214 participants
received alendronate. New results from the study, part of the landmark Fracture
Intervention Trial (FIT), are published in the December 23 issue of the Journal of
American Medical Association (JAMA).
"Our study demonstrates that women who are concerned about osteoporosis or are over
60 or 65 years of age should have a bone density test so that they can be proactive about
bone fracture prevention," said Steven R. Cummings, UCSF professor of medicine and
epidemiology and lead author of the study. "Women who do test positive for
osteoporosis are at a very high risk of suffering a fracture, and should talk with their
doctors about alendronate or other therapy for osteoporosis."
FIT, which included 6,000 patients, had two arms: the Vertebral Fracture Arm, which was
previously reported at the 1997 American Society for Bone and Mineral Research Meeting and
that included women who had a spinal fracture, and the Clinical Fracture Arm, which is the
subject of this current study being reported in JAMA and that included women without
spinal fractures.
Because 10 to 15 percent of postmenopausal women have spinal fractures, UCSF researchers
aimed to determine in this arm of the study whether four years of treatment with
alendronate would reduce the risk of fractures in the large number of postmenopausal women
who have a low bone mineral density (BMD), and therefore thin bones, but no spinal
fractures.
Cummings reported that the effect of alendronate on fractures depended on a woman's
initial hip bone density measured at the beginning of the study, an indicator of whether
or not she had osteoporosis. Those with the lowest BMD -- and therefore the thinnest, most
fragile bones, who are at the highest risk of fractures -- benefited the most from
alendronate. Women with osteoporosis were defined as those having a hip BMD 2.5 standard
deviations below the normal mean.
The women in the study with a low enough BMD to qualify as osteoporotic experienced
dramatic benefits from alendronate. However, those who did not have a low enough BMD to be
classified as having osteoporosis did not experience a reduction in the risk of fractures
from taking the drug. All the women who received the drug during the four-year study did
have a significant increase in BMD at the hip and spine, Cummings said.
He added that approximately one in five women who have osteoporosis -- a disease that
affects millions of women worldwide -- don't know it. This is particularly dangerous
because the bone weakening condition, if not treated appropriately, can lead to painful
fractures that may greatly impact a woman's health and quality of life. In fact,
osteoporosis results in 1.5 million fractures each year, over 400,000 hospital admissions,
more than 44 million patient days in nursing homes, and $13.8 billion in health care
expenditures among women and men in the US.
Links:
Full press release
JAMA
Drug Reduces Fracture Risk for
Healthy Women With Thin Bones, UCSF Study Finds
Source: Abby Sinnott, News
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