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Once-Weekly Alendronate Effective In Treating Postmenopausal Osteoporosis

Once-weekly alendronate provides women with the most convenient option for the treatment of postmenopausal osteoporosis, Swiss clinicians have found in a large double-blind trial over two years.

The study among 1,258 women by clinicians at the Department of Internal Medicine, Hopital Cantonal, Geneva, was a continuation of an original one-year study to show that once-weekly dosing with 70 mg of alendronate (seven times the daily oral dose) and twice-weekly dosing with 35 mg, is equivalent to the 10-mg once-daily regimen. The extended trial also allowed them to gain more extensive safety experience with this new dosing regimen.

The cohort of postmenopausal women, between the ages of 42 and 85, had osteoporosis and bone mineral density [BMD) of either lumbar spine or femoral neck at least 2.5 SDs below peak young adult mean, or a prior vertebral or hip fracture. Five hundred and nineteen women were assigned to receive oral once-weekly alendronate at 70 mg, another 369 women to receive twice-weekly alendronate at 35 mg , and 370 women to receive daily alendronate at 10 mg, for a total of two years of double-blind experience.

It was found that the mean BMD increases from baseline at 24 months at the lumbar spine were 6.8 percent in the once-weekly group, 7.0 percent in the twice-weekly group, and 7.4 percent in the daily treatment group. Total hip BMD increases were 4.1 percent in the once-weekly group, 4.3 percent in the twice-weekly groups and 4.3 percent in the daily treatment group.

Similar increases were seen among the women in whatever dosing regimen for BMD increases at the femoral neck, trochanter, and total body. In addition, similar results for the regimens were seen in the reductions of biochemical markers of bone resorption (urinary cross-linked N-telopeptides of type I collagen [NTx]), and bone formation (serum bone-specific alkaline phosphatase [BSAP]).

All of the regimens were well tolerated, and the women experienced similar incidences of upper gastrointestinal adverse events. The incidence rates of clinical fractures were similar among the three groups.

The clinicians concluded that not only is once-weekly alendronate is therapeutically equivalent to daily dosing, this regimen also provides women "with a more convenient dosing option that may potentially enhance adherence to therapy."
J Bone Miner Res 2002 Nov;17(11):1988-96. "Two-year results of once-weekly administration of alendronate 70 mg for the treatment of postmenopausal osteoporosis."

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