title: Comparison of biochemical markers of bone remodelling in the assessment of the effects of alendronate on bone in postmenopausal osteoporosis.
abstract: The effects of alendronate treatment on biochemical markers of bone remodelling and bone mineral density (BMD) were studied in 30 Caucasian women (postmenopausal for at least 3 years, age 42-76 years, with BMD of the lumbar spine at least 2 S.D. below the mean for mature, premenopausal women). The patients were randomly assigned to receive alendronate (10 mg/day) or placebo for 12 months (double blind). The study was subsequently extended to a second year of open alendronate treatment. The treatment with alendronate resulted in a significant and progressive increase in BMD of the lumbar spine and femoral neck. Under the treatment, the maximal decrease of biochemical markers of bone remodelling (osteocalcin in plasma, bone-specific alkaline phosphatase, N-terminal propeptide of type I procollagen and C-terminal telopeptide of type I collagen in serum, and cross-linked amino-terminal N-telopeptide and total hydroxyproline in urine) was observed at 6 months with no further change during the 2-year period. There were no significant differences in discriminating between patients treated for 1 year with alendronate or placebo using either the percentage change in spine BMD at month 12, or a single measurement of the marker at month 6, or log (percent of baseline at month 6 of value of the marker). In this respect, the power of all the biochemical markers were comparable. The markers are a valuable adjunct to the measurements of BMD, especially in the patients not showing an increase of 3% or more at the lumbar spine BMD after 1 year of treatment.
authors.affiliation: 3rd Department of Internal Medicine, Charles University Faculty of Medicine, Prague, Czech Republic. stepan@mbox.vol.cz
authors.forename: J J
authors.initials: JJ
authors.lastname: Stĕpán
authors.forename: J
authors.initials: J
authors.lastname: Vokrouhlická
mesh_terms: D000328:Adult; D000368:Aged; D019386:Alendronate / Q000494:pharmacology / Q000627:therapeutic use*; D015415:Biomarkers / Q000032:analysis* / Q000097:blood; D015519:Bone Density; D016723:Bone Remodeling / Q000187:drug effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy*; D010919:Placebos; D017698:Postmenopause
chemical_list: D015415:Biomarkers; D010919:Placebos; D019386:Alendronate