Prevention of Bone Loss With Alendronate in Postmenopausal Women Under 60 Years of Age

Hosking, D. J.; Chilvers, C. E. D.; Christiansen, Claus; Ravn, Pernille; Wasnich, Richard D.; Ross, Philip D.; McClung, Michael R.; Balske, A.; Thompson, David D.; Daley, M.; Yates, A.J.P.

doi:10.1097/00006254-199806000-00021

Cited by 118 publications

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“…Bisphosphonates significantly prevent bone loss and osteoporotic fractures in postmenopausal women (Storm et al, 1990;Watts et al, 1990;Harris et al, 1993;Liberman et al, 1995;Black et al, 1996;Karpf et al, 1997;Cummings et al, 1998;Hosking et al, 1998). Tamoxifen has an oestrogen-agonistic effect on bone and therefore also prevents bone loss in postmenopausal women (Love et al, 1992;Ward et al, 1993;Kristensen et al, 1994;Grey et al, 1995;Powles et al, 1996).…”

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confidence: 99%

The effect of clodronate and antioestrogens on bone loss associated with oestrogen withdrawal in postmenopausal women with breast cancer

et al. 2001

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SummaryIn this study we report bone mineral density (BMD) changes during clodronate and antioestrogen treatment in women with breast cancer having discontinued hormone replacement therapy (HRT) at the time of operation compared to women who had not used HRT immediately before the operation. 61 postmenopausal women with operable breast cancer were treated with the adjuvant antioestrogen tamoxifen 20 mg or toremifene 60 mg daily for 3 years. All patients were randomized to clodronate (1.6 g daily orally) or control groups for 3 years. 23 patients had recently (recent users) and 38 never or not for at least 1 year before operation used HRT (non-users). BMD of lumbar spine and femoral neck were measured before antiresorptive therapy (antioestrogens and clodronate) and at 1, 2, 3 and 5 years thereafter. All patients were disease-free at the time of BMD measurements. Patients who had recently used HRT had more significant bone loss as compared to HRT non-users at 3 years in lumbar spine -3.0% vs. + 1.2% (P < 0.001), but not in femoral neck -0.4% vs. + 1.7% (P = 0.27). Adding 3-year clodronate treatment to antioestrogen therapy improved BMD marginally at 3 years: lumbar spine + 1.0% vs. -1.7% (P = 0.01) and femoral neck + 2.4% vs. -0.4% (P = 0.12). This was also seen at 5 years of follow-up, 2 years after termination of the antiresorptive therapy: HRT recent users vs. HRT non-users in lumbar spine -6.5% vs. +0.5% (P < 0.0001) and in femoral neck -4.8% vs. -1.5% (P = 0.38); and clodronate vs. controls in lumbar spine -1.0% vs. -3.2% (P = 0.06) and in femoral neck -0.1% vs. -5.2% (P = 0.001, respectively). The type of endocrine therapy (tamoxifen and toremifene) had no significant influence on BMD changes. We conclude from this study that postmenopausal women who have recently discontinued HRT experience more rapid bone loss than HRT non-users. Neither 3-year antioestrogen therapy alone nor antioestrogen together with clodronate could totally prevent the bone loss related to HRT withdrawal in lumbar spine, even though clodronate seemed to retard it.

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The effect of clodronate and antioestrogens on bone loss associated with oestrogen withdrawal in postmenopausal women with breast cancer

et al. 2001

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“…Estrogens have been shown to improve bone mineralization and metabolism. 83 Chaudry and colleagues have found that estrogens have a positive effect on inflammation and hypermetabolism and improve survival in a trauma hemorrhage model. [84][85][86][87] In the present study, we found that estrogen was significantly decreased immediately after the injury but increased during hospital stay, while testosterone decreased and progesterone increased over time.…”

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confidence: 99%

The Pathophysiologic Response to Severe Burn Injury.

Jeschke

Finnerty

Norbury

et al. 2006

Critical Care Medicine

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Objective-To improve clinical outcome and to determine new treatment options, we studied the pathophysiologic response postburn in a large prospective, single center, clinical trial.Summary Background Data-A severe burn injury leads to marked hypermetabolism and catabolism, which are associated with morbidity and mortality. The underlying pathophysiology and the correlations between humoral changes and organ function have not been well delineated.Methods-Two hundred forty-two severely burned pediatric patients [>30% total body surface area (TBSA)], who received no anabolic drugs, were enrolled in this study. Demographics, clinical data, serum hormones, serum cytokine expression profile, organ function, hypermetabolism, muscle protein synthesis, incidence of wound infection sepsis, and body composition were obtained throughout acute hospital course.Results-Average age was 8 ± 0.2 years, and average burn size was 56 ± 1% TBSA with 43 ± 1% third-degree TBSA. All patients were markedly hypermetabolic throughout acute hospital stay and had significant muscle protein loss as demonstrated by a negative muscle protein net balance (−0.05% ± 0.007 nmol/100 mL leg/min) and loss of lean body mass (LBM) (−4.1% ± 1.9%); P < 0.05. Patients lost 3% ± 1% of their bone mineral content (BMC) and 2 ± 1% of their bone mineral density (BMD). Serum proteome analysis demonstrated profound alterations immediately postburn, which remained abnormal throughout acute hospital stay; P < 0.05. Cardiac function was compromised immediately after burn and remained abnormal up to discharge; P < 0.05. Insulin resistance appeared during the first week postburn and persisted until discharge. Patients were hyperinflammatory with marked changes in IL-8, MCP-1, and IL-6, which were associated with 2.5 ± 0.2 infections and 17% sepsis.Conclusions-In this large prospective clinical trial, we delineated the complexity of the postburn pathophysiologic response and conclude that the postburn response is profound, occurring in a timely manner, with derangements that are greater and more protracted than previously thought.

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“…Diferentes estudios han demostrado la eficacia a largo plazo de alendronato en mujeres con osteoporosis [15][16][17][18][19][20][21] . Las conclusiones de los diferentes trabajos publicados son que alendronato aumenta la densidad ósea tanto a nivel de hueso cortical (antebrazo y cuello femoral) como trabecular (columna vertebral).…”

Section: Alendronatounclassified

Tratamiento de la osteoporosis postmenopáusica

Loza

2003

Anales Sis San Navarra

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RESUMENEl tratamiento de la osteoporosis en mujeres postmenopáusicas consiste en medidas farmacológicas y no farmacológicas. La terapia hormonal sustitutiva hasta épocas recientes era considerada una terapia de primera línea para la prevención de la osteoporosis postmenopáusica. Sin embargo, los datos derivados del estudio Women´s Health Initiative (WHI) revelaron que el tratamiento combinado estrógenos-progestáge-nos no reduce el riesgo de enfermedad coronaria sino que además aumenta el riesgo de cáncer de mama, ictus y eventos tromboembólicos venosos. Por este motivo actualmente el tratamiento de elección de la osteoporosis postmenopáusica lo constituyen otros agentes antiresortivos.Palabras clave. Osteoporosis postmenopáusica. Tratamiento. Bifosfonatos. Raloxifeno. Calcitonina. ABSTRACTPrevention and treatment of osteoporosis consists of non-drug and drug therapy. This review of the topic will provide an overview of the approach to therapy of osteoporosis in postmenopausal women. In the past, estrogen replacement was considered a primary therapy for the prevention of postmenopausal osteoporosis. However, data from the Women´s Health Initiative (WHI) revealed that estrogen-progestine therapy does not reduce the risk of coronary heart disease, and increases the risk of breast cancer, stroke, and venous thromboembolic events. As a result of these findings, other antiresorptive agents are now the drugs of choice for the prevention and treatment of osteoporosis in postmenopausal women.

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Prevention of Bone Loss With Alendronate in Postmenopausal Women Under 60 Years of Age

Cited by 118 publications

References 0 publications

The effect of clodronate and antioestrogens on bone loss associated with oestrogen withdrawal in postmenopausal women with breast cancer

The effect of clodronate and antioestrogens on bone loss associated with oestrogen withdrawal in postmenopausal women with breast cancer

The Pathophysiologic Response to Severe Burn Injury.

Tratamiento de la osteoporosis postmenopáusica

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