Effect of alendronate in elderly patients after low trauma hip fracture repair

• Published in: Osteoporosis international 2009-06, Vol.20 (6), p.903-910
• Main Authors: Cecilia, D., Jódar, E., Fernández, C., Resines, C., Hawkins, F.
• Format: Article
• Language: English
• Subjects: Accidental Falls - statistics & numerical data; Aged, 80 and over; Alendronate - therapeutic use; Biological and medical sciences; Bone density; Bone Density - drug effects; Bone Density Conservation Agents - therapeutic use; Confidence Intervals; Diseases of the osteoarticular system; Dose-Response Relationship, Drug; Drug therapy; Effects; Endocrinology; Female; Fractures; Hip Fractures - drug therapy; Hip Fractures - surgery; Hip joint; Humans; Injuries of the limb. Injuries of the spine; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Medicine; Medicine & Public Health; Older people; Original Article; Orthopedics; Osteoarticular system. Muscles; Osteoporosis - complications; Osteoporosis - drug therapy; Osteoporosis. Osteomalacia. Paget disease; Prospective Studies; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Rheumatology; Traumas. Diseases due to physical agents; Treatment Outcome
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-008-0767-z

Summary One year of once weekly alendronate, when given shortly after the surgical repair of a hip fracture, produces reductions in bone markers and increases proximal femoral bone density. The therapy was well tolerated. Introduction Hip fracture is the most devastating type of osteoporotic fracture and increases notably the risk of subsequent fractures. The aim of this paper was to evaluate the effects of 1 year therapy with a weekly dose of alendronate in the bone mineral density and bone markers in elderly patients after low trauma hip fracture repair. Methods Two hundred thirty-nine patients (81 ± 7 years; 79.8% women) were randomized to be treated either with calcium (500 mg/daily) and vitamin D 3 (400 IU/daily; Ca–Vit D group) or with alendronate (ALN, 70 mg/week) plus calcium and vitamin D 3 (500 mg/daily and 400 IU/daily, respectively; ALN + Ca–Vit D group). Results One hundred forty-seven (61.5%) patients completed the trial. Alendronate increased proximal femoral bone mineral density (BMD) in the intention-to-treat analysis (mean difference (95% confidence interval); total hip 2.57% (0.67; 4.47); trochanteric 2.96% (0.71; 5.20), intertrochanteric 2.32% (0.36; 4.29)), but the differences were not significant in the BMD of the femoral neck (0.47%; (−2.03; 2.96) and the lumbar spine (0.69%; (−0.86; 2.23)). Bone turnover markers decreased during alendronate treatment. Conclusion The present study demonstrates for the first time the anti-resorptive efficacy of alendronate given immediately after surgical repair in an elderly population with recent hip fracture. This effect should positively affect the rate of subsequent fractures.