on 50 years of age, a postmenopausa...

on 50 years of age, a postmenopausal white woman has at least a 40 percent chance of having an osteoporotic fracture during the remainder of her life. In each age clump the fracture risk for osteoporotic women is four times that of women without osteoporosis. Rigid dosing requirements have been implicated in the relatively gentle participation in therapies to obstruct osteoporosis, even among high-risk women Bisphosphonate therapy has a compage regimen that can be inconvenient for many women Patients must take the tablet while fasting and then remain upright and avoid feed or other medication for at least 30 minutes to minimize esophageal irritation. Luckey and colleagues studied the efficacy and safety of alendronate in a once-weekly dosage of 35 mg

Healthy postmenopausal women 40 to 70 years of age with no evidence of osteoporosis onward bone density scans and radiography were recruited at 43 center in seven countries. Exclusion criteria were the mien of upper gastrointestinal bleeding or signif in a dosage of 35 mg weekly plus placebo tablets upon other days. The remaining 361 women took alendronate in a dosage of 5 mg daily. All participants received the same instructions for taking medications, and all received 500 mg of calcium plus 250 mg of vitamin D daily.

Participants were followed at undivided three, six, and 12 month by dint of clinical interview and examination, plus laboratory assessment, including markers of bone turnover. Bone mineral density in the lumbar spine and hip was assessed at baseline and at the close of the study. Any clinical report suggesting fracture was radiologically investigated. All radiographs and bone scans were interpreted from staff who were unaware of treatment allocation.

The couple groups were comparable at the beginning of the contemplation Women in both groups showed significant gains in bone density during treatment (see accompanying table), with no significant differences. The clusters also were similar in biochemical markers of bone turnover. No serious adverse purports were reported, but about 25 percent of women in each arrange had gastrointestinal events. The rates of discontinuation from adverse tenors were 9.4 percent in women forward daily therapy and 5.2 percent in those in succession weekly treatment. No vertebral fractures or cases of esophagitis occurr during the study

The authors close that alendronate in a dosage of 35 mg formerly per week provides comparable efficacy to daily treatment with 5 mg for osteoporosis. The weekly treatment was well tolerated and associated with somewhat fewer adverse tenors and greater convenience.

Luckey MM et al. Therapeutic equivalence of alendronate 35 milligrams formerly weekly and 5 milligrams daily in the prevention of postmenopausal osteoporosis. Obstet Gynecol April 2003;101:711-21

ANNE D WALLING, MD

COPYRIGHT 2003 American Academy of Family Physicians

COPYRIGHT 2003 Gale Group