title: Continuous and cyclical clodronate therapies and bone density in postmenopausal bone loss.
abstract: OBJECTIVE
  To evaluate the effectiveness of different clodronate regimens in postmenopausal osteoporosis.
  
  
  METHODS
  In groups of 20, 60 women were randomly assigned to one of three treatments: oral calcium, 1000 mg/day; oral calcium plus oral clodronate, 400 mg/day; oral calcium plus oral clodronate, 400 mg/day for 30 days, followed by a 60-day period of calcium supplement alone. This last regimen was repeated four times in the 12-month study period.
  
  
  RESULTS
  Patients who received calcium alone showed a decline in spinal bone mass, both after 6 and 12 months (P < .03 and P < .005, respectively); femoral density in this group also decreased after 6 and 12 months (P < .002 and P < .05, respectively). On the other hand, both clodronate-treated groups had increased levels of lumbar bone mass compared with controls, both after 6 and 12 months of therapy. However, at the end of the study, patients treated with cyclical clodronate had higher spinal bone mass compared with those treated continuously (3.32 +/- 0.71 versus 0.43 +/- 0.89%, P < .02). After 6 months, femoral bone density was significantly higher both in subjects treated with clodronate, both cyclically and continuously (P < .01), compared with controls. Continuous clodronate treatment resulted in a clear fall in biochemical indices of bone resorption, together with a consequent decrease in osteocalcin at 6 (P < .02) and 12 months (P < .003) and a significant increase in parathyroid hormone after 12 months (P < .001) of therapy.
  
  
  CONCLUSIONS
  One-year treatment with clodronate induces a gain in bone mass, especially in the spine. The continuous regimen does not result in any further benefit in lumbar bone density over the cyclical one, probably because of a greater suppression of bone turnover.
authors: Institute of Internal Medicine, University of Padova, Italy.
authors: S
authors: S
authors: Giannini
authors: A
authors: A
authors: D'Angelo
authors: L
authors: L
authors: Sartori
authors: G
authors: G
authors: Passeri
authors: L
authors: L
authors: Dalle Carbonare
authors: G
authors: G
authors: Crepaldi
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D015519:Bone Density / Q000187:drug effects*; D016723:Bone Remodeling / Q000187:drug effects; D002118:Calcium / Q000008:administration & dosage / Q000627:therapeutic use; D004002:Clodronic Acid / Q000008:administration & dosage* / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000175:diagnosis / Q000188:drug therapy*; D013997:Time Factors
chemical_list: D004002:Clodronic Acid; D002118:Calcium