title: Effects of alendronate and hormone replacement therapy, alone or in combination, on bone mass in postmenopausal women with osteoporosis: a prospective, randomized study.
abstract: The effectiveness of hormone replacement therapy (HRT) and alendronate, alone and in combination, was evaluated in 120 postmenopausal patients with osteoporosis with bone mineral density (BMD) measurements at least 2 SD below the mean value for young premenopausal subjects. They had no contra-indications to HRT or alendronate use and were randomized to three different treatment groups. Group I was treated with micronized 17 beta-oestradiol 2 mg and norethisterone acetate 1 mg/day per os, group II received alendronate 10 mg/day per os and group III received micronized 17 beta-oestradiol 2 mg, norethisterone acetate 1 mg/day per os and alendronate 10 mg/day per os for 1 year. Elementary calcium 1500 mg/day was supplied to patients in all three groups. Spinal and femoral neck BMD and markers of bone mineral metabolism were measured on each patient before treatment and 6 and 12 months after treatment in 95 patients. At the end of the 12th month, significant increases in spinal and femoral neck BMD were found in all groups. Increases in spinal BMD were significantly higher in patients treated with alendronate and alendronate with HRT when compared with patients treated with HRT only. No significant difference was found in femoral neck BMD changes between the groups. Significant decreases in bone resorption and markers of bone formation were observed in all groups. Alendronate was found to be more effective than HRT and could have a very beneficial effect when added to the HRT regimen in patients with postmenopausal osteoporosis. Alendronate might also be used in postmenopausal patients with osteoporosis when HRT is contra-indicated or when there is reluctance to use hormonal treatment.
authors.affiliation: Gazi University School of Medicine, Department of Obstetrics and Gynecology, Besevler, Ankara, Turkey. btiras@tr-net.net.tr
authors.forename: M B
authors.initials: MB
authors.lastname: Tiraş
authors.forename: V
authors.initials: V
authors.lastname: Noyan
authors.forename: A
authors.initials: A
authors.lastname: Yildiz
authors.forename: M
authors.initials: M
authors.lastname: Yildirim
authors.forename: S
authors.initials: S
authors.lastname: Daya
mesh_terms: D019386:Alendronate / Q000494:pharmacology*; D000469:Alkaline Phosphatase / Q000097:blood / Q000187:drug effects; D015519:Bone Density / Q000187:drug effects*; D004958:Estradiol / Q000494:pharmacology; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D008875:Middle Aged; D009640:Norethindrone / Q000494:pharmacology; D015675:Osteocalcin / Q000187:drug effects; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy* / Q000378:metabolism; D017698:Postmenopause; D011446:Prospective Studies
chemical_list: D015675:Osteocalcin; D004958:Estradiol; D000469:Alkaline Phosphatase; D009640:Norethindrone; D019386:Alendronate