my personal edition > hrt > news


  E-Mail this DGReview to a colleague

DGReview

Alendronate Helps Save Bone After Hormone Replacement Therapy Discontinued

Alendronate prevents the loss of bone density experienced by many postmenopausal women who discontinue hormone replacement therapy (HRT), reports an international, randomised trial.

The blinded 12-month study found a high rate of bone loss in postmenopausal women with low bone mineral density (BMD) in the first 12 to 15 months after stopping HRT. Treatment with alendronate increased or maintained both spine and hip BMD and prevented the increase in bone resorption associated with HRT withdrawal.

Dr Brynne H. Ascott-Evans from the Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa led this multi-centre assessment of the effect of alendronate sodium in these women. The 144 participants, all of whom had low BMD and had recently discontinued HRT, were randomly selected to receive either a daily dose of 10 mg of alendronate sodium or matching placebo.

Main outcome measures were spine, hip and total body BMD; biochemical markers of bone turnover; and tolerability.

There was a 2.3% mean increase in spine BMD in women on alendronate as compared with a mean loss of 3.2% in patients on placebo (a difference of 5.5%).

The women on alendronate also showed greater hip and total body BMD preservation than did those on placebo.

Whereas bone turnover decreased significantly with alendronate (bone-specific alkaline phosphatase levels decreased by 20% and urinary N-telopeptide/creatinine ratio by 47%), it increased in the placebo group (by 18% and 36%, respectively). Moreover, alendronate was well tolerated, with no increase over placebo in adverse events.
Arch Intern Med 2003;163:7:789-794. "Alendronate Prevents Loss of Bone Density Associated With Discontinuation of Hormone Replacement Therapy: A Randomized Controlled Trial"

E-Mail this DGReview to a colleague

To print, use this version