Usefulness of addition of alendronate to ongoing hormone replacement therapy in postmenopausal women with low bone mineral desity

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  • MORISHIMA Shuji
    Department of Obstetrics and Gynecology, Kobe West City Hospital
  • MATSUO Hiroya
    Faculty of Health Sciences, Kobe University School of Medicine
  • HIRAMATSU Shinsuke
    Department of Obstetrics and Gynecology, Shin-nittetsu Hirohata Hospital
  • MARUO Takeshi
    Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine

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  • ホルモン補充療法中の低骨密度閉経後女性に対するアレンドロネート追加併用の有用性に関する検討

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Abstract

Synopsis A chronic imbalance in the bone-remodeling process results in a net excess of bone resorption over bone formation, producing a loss of bone mass and alteration of architecture. Available antiresorptive agents increase bone mineral density (BMD) and reduce fractures in women with postmenopausal osteoporosis. Bisphosphonate and estrogen are effective in the management of postmenopausal osteoporosis, but the efficacy and safety of alendronate added to ongoing hormone replacement therapy (HRT) are unknown. The objective of the present study was to evaluate the effects of alendronate added to ongoing HRT on BMD and on biochemical markers of bone turn over in postmenopausal women with low BMD.<br> A total of 26 postmenopausal women with low BMD, who had been receiving HRT for at least 4 months, received either HRT alone (n=16) or HRT plus alendronate (5mg/day, n=10).<br> A 8-month treatment with alendronate plus HRT resulted in a significant increase in lumbar spine BMD compared with HRT alone (p<0.05). The postmenopausal women with HRT plus alendronate were divided into two groups, the Greater-BMD increase (†3.5%) and Less-BMD increase (<3.5%) group, based on the median variation in BMD (3.5%) at 8-month treatment. The pretreatment deoxypyridinoline (DP) levels and the variation in DP levels at 8-month treatment were significantly larger in the Greater-BMD increase group than the those in Less-BMD increase group , respectively (p<0.05) .<br> This study demonstrated that alendronate added to HRT significantly increased BMD at the lumbar spine in postmenopausal women with low BMD despite ongoing HRT, and that DP levels at pretreatment might have a predictive value in evaluating whether BMD are increased by addition of alendronate to ongoing HRT. [Adv Obstet Gynecol, 56(2) : 70-76, 2004(H16.5)]<br>

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