Effect of inappropriate and continuous therapy with alendronate for ten years on skeletal integrity — Observations in two elderly patients
- 26 Downloads
Alendronate is a potent aminobisphosphonate that has been used worldwide to decrease fracture risk in millions of post-menopausal women with and without osteoporosis, men with low bone mass, and in those with glucocorticoid-induced osteoporosis. A recent report of 9 patients with spontaneous atypical non-vertebral fractures during treatment with alendronate for up to 8 yr raised questions suggesting the possibility of severe suppression of bone turnover and resultant susceptibility to fracture. Our recent observations in 2 elderly women with inactive monostotic Paget’s disease of bone who had been treated elsewhere continuously for this disease with alendronate for 10 yr at doses overall of 2 and 4 times the osteoporotic dose provided an opportunity to engage in the ongoing controversy over long-term safety of bisphosphonate therapy. Despite such therapy, skeletal integrity was maintained with normal bone densities and the absence of skeletal fractures. These observations do not support the suggestion of deleterious effects with long-term alendronate therapy.
Key-wordsAlendronate osteoporosis fractures Paget’s disease bone turnover
Unable to display preview. Download preview PDF.
- 1.Liberman UA, Weiss SR, Bröll J, et al. Effect of oral alendronate on bone mineral density and the incidence of fractures in postmenopausal osteoporosis. The Alendronate Phase III Osteoporosis Treatment Study Group. N Engl J Med 1995, 333: 1437–43.Google Scholar
- 2.McClung M, Clemmesen B, Daifotis A, et al. Alendronate prevents postmenopausal bone loss in women without osteoporosis. A double-blind, randomized, controlled trial. Alendronate Osteoporosis Prevention Study Group. Ann Intern Med 1998, 128: 253–61.Google Scholar
- 3.Black DM, Cummings SR, Karpf DB, et al. Randomized trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Fracture Intervention Trial Research Group. Lancet 1996, 348: 1535–41.Google Scholar
- 5.Saag KG, Emkey R, Schnitzer TJ, et al. Alendronate forthe prevention and treatment of glucocorticoid-induced osteoporosis. Glucocorticoid-Induced Osteoporosis Intervention Study Group. N Engl J Med 1998, 339: 292–9.Google Scholar
- 8.Bone HG, Downs RW Jr, Tucci JR, et al. Dose-response relationships for alendronate treatment in osteoporotic women. Alendronate Elderly Osteoporosis Study Centers. J Clin Endocrinol Metab 1997, 82: 265–74.Google Scholar
- 13.Tonino RP, Meunier PJ, Emkey R, et al. Skeletal benefits of alendronate: 7-year treatment of postmenopausal osteoporotic women. Phase III Osteoporosis Treatment Study Group. J Clin Endocrinol Metab 2000, 85: 3109–15.Google Scholar
- 15.Balena R, Markatos A, Guy J, et al. Effect of three years treatment with alendronate in adult beagles. J Bone Miner Res 1993, 8: S270 (abstract).Google Scholar