J Korean Med Sci.  2017 Jun;32(6):992-998. 10.3346/jkms.2017.32.6.992.

Effects of Combination Therapy of Alendronate and Hormonal Therapy on Bone Mineral Density in Postmenopausal Korean Women: Multicenter, Randomized Controlled Clinical Trial

Affiliations
  • 1Department of Obstetrics and Gynecology, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 2Department of Obstetrics and Gynecology, Hallym University College of Medicine, Anyang, Korea.
  • 3Department of Obstetrics and Gynecology, Hanyang University School of Medicine, Seoul, Korea.
  • 4Department of Obstetrics and Gynecology, Chung-Ang University College of Medicine, Seoul, Korea.
  • 5Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea. ymchoi@snu.ac.kr
  • 6The Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea.

Abstract

This study evaluated the effects of combination treatment with alendronate (ALEN) and hormone therapy (HT) on bone mineral density (BMD) in postmenopausal Korean women. This multicenter, randomized, controlled clinical trial enrolled 344 postmenopausal women with low BMD. The women received HT (0.625 mg/day of conjugated equine estrogen and 2.5 mg/day of medroxyprogesterone acetate) alone or in combination with ALEN (10 mg/day) for 1 year. Changes in BMD and biochemical markers of bone turnover were evaluated. Data from 203 women (HT alone, 99; combination treatment, 104) who completed this study were analyzed. BMD at the lumbar spine and total hip increased significantly in both treatment groups after 1 year. There were no significant differences between HT alone vs. the combination of ALEN and HT in mean BMD increase at the lumbar spine (6.9% vs. 7.9%) and total hip (3.7% vs. 3.8%). Combined therapy suppressed serum osteocalcin and urinary deoxypyridinoline to a greater extent than HT alone. In conclusion, compared to HT alone, combination treatment with ALEN and HT for 1 year did not offer a benefit in BMD in postmenopausal Korean women with low BMD.

Keyword

Osteoporosis; Bone Mineral Density; Combination Therapy; Alendronate; Hormone Therapy

MeSH Terms

Alendronate*
Biomarkers
Bone Density*
Bone Remodeling
Estrogens
Female
Hip
Humans
Medroxyprogesterone
Osteocalcin
Osteoporosis
Spine
Alendronate
Biomarkers
Estrogens
Medroxyprogesterone
Osteocalcin

Figure

  • Fig. 1 Flow diagram of the study.

  • Fig. 2 Mean percent changes in BMD. Differences between the 2 groups were not significant.BMD = bone mineral density, HT = hormone therapy, ALEN = alendronate. * P < 0.05 vs. baseline.

  • Fig. 3 Mean changes in biochemical markers of bone turnover. (A) OC, (B) DPD. Combination therapy suppressed serum levels of osteocalcin and urinary DPD by a significantly greater extent than HT alone at each time point.OC = osteocalcin, DPD = deoxypyridinoline, HT = hormone therapy, ALEN = alendronate. * P < 0.05 vs. baseline; † P < 0.05 vs. HT alone.


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