WASHINGTON -- Daily oral alendronate is more effective than daily intranasal calcitonin among postmenopausal women with osteoporosis, Dr. Clifford J. Rosen said at an international symposium on women's health and menopause.
Alendronate (Fosamax), a bisphosphonate that inhibits bone resorption, has been shown to increase bone mineral density and reduce fractures in osteoporosis patients. Calcitonin, a polypeptide, is thought to augment bone formation by increasing osteoblast activity, he said.
The two agents were directly compared in a 2-year, multi-center study involving 275 women with osteoporosis. "No prior study has compared therapeutic doses of alendronate and calcitonin in a parallel design," said Dr. Rosen, director of the Maine Center for Osteoporosis Research and Education at St. Joseph Hospital in Bangor.
This study was supported in part by Merck & Co. Inc., West Point, Pa., maker of Fosamax.
The study subjects were women aged 45 years and older who had been postmenopausal for at least 5 years and younger women who had undergone surgical menopause at least 5 years previously.
During the first year of the study, the subjects were randomly assigned to receive either 10 mg of oral alendronate, 200 IU of calcitonin nasal spray, or an oral placebo every day. During the second year, women who had received the placebo were switched to oral alendronate.
All patients received daily calcium and vitamin D supplements as well, Dr. Rosen said in a poster presentation at the meeting, which was also sponsored by the National Institutes of Health, the International Menopause Society, and the North American Menopause Society.
Dual x-ray absorptiometry scanning showed that alendronate produced significantly greater increases in bone mineral density at the hip trochanter, lumbar spine, and femoral neck than did calcitonin or placebo. Calcitonin outperformed placebo only at the lumbar spine site.
Alendronate also produced greater decreases in urinary Ntelopeptide and serum bone-specific alkaline phosphatase, both markers of bone turnover. Calcitonin also decreased bone-specific alkaline phosphatase levels, compared with placebo, but to a lesser degree than did alendronate.
During the second year of the study, women who switched from placebo to alendronate showed a significant increase in bone mineral density and a decrease in both biochemical markers of bone turnover, Dr. Rosen noted.
COPYRIGHT 2001 International Medical News Group
COPYRIGHT 2001 Gale Group
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