title: Comparison of weekly treatment of postmenopausal osteoporosis with alendronate versus risedronate over two years.
abstract: OBJECTIVE
  A 1-yr extension of the Fosamax Actonel Comparison Trial was completed to compare changes in bone mineral density (BMD), bone turnover, and upper gastrointestinal tolerability over 2 yr of treatment.
  
  
  METHODS
  This was a randomized, double-blind extension conducted at 72 U.S. sites.
  
  
  METHODS
  Of the 1053 women who completed yr 1, 833 postmenopausal women with low BMD entered the extension, continuing their same treatment allocation [once-weekly (OW) alendronate 70 mg or OW risedronate 35 mg]. Changes in BMD at the hip trochanter, total hip, femoral neck, and lumbar spine and in markers of bone turnover were compared at 24 months. Tolerability was assessed by adverse experience reporting.
  
  
  RESULTS
  Alendronate produced greater increases from baseline in BMD at 24 months than did risedronate at the trochanter (alendronate, 4.6%; risedronate, 2.5%, P < 0.001) as well as at all other BMD sites. Significantly more alendronate than risedronate patients had measured BMD increases of 0% or more and 3% or more at all BMD sites (P < 0.001), and fewer alendronate patients had measured decreases of 3% or more at all BMD sites. Significantly greater reductions in all biochemical markers of bone turnover occurred with alendronate, compared with risedronate. No differences were seen in occurrence or discontinuations due to upper gastrointestinal adverse experiences.
  
  
  CONCLUSIONS
  Patients receiving 70 mg OW alendronate had greater gains in BMD, were more likely to maintain or gain BMD, and had greater reductions in bone turnover markers than patients receiving 35 mg OW risedronate after 24 months, with no differences in upper gastrointestinal tolerability.
authors.affiliation: Clinical Research Center of North Texas, 2921 Country Club Road, Suite 101, Denton, Texas 76210, USA. sbonnick@msn.com
authors.forename: Sydney
authors.initials: S
authors.lastname: Bonnick
authors.forename: Kenneth G
authors.initials: KG
authors.lastname: Saag
authors.forename: Douglas P
authors.initials: DP
authors.lastname: Kiel
authors.forename: Michael
authors.initials: M
authors.lastname: McClung
authors.forename: Marc
authors.initials: M
authors.lastname: Hochberg
authors.forename: Sherri-Ann M
authors.initials: SM
authors.lastname: Burnett
authors.forename: Anthony
authors.initials: A
authors.lastname: Sebba
authors.forename: Risa
authors.initials: R
authors.lastname: Kagan
authors.forename: Erluo
authors.initials: E
authors.lastname: Chen
authors.forename: Desmond E
authors.initials: DE
authors.lastname: Thompson
authors.forename: Anne E
authors.initials: AE
authors.lastname: de Papp
mesh_terms: D000368:Aged; D019386:Alendronate / Q000008:administration & dosage* / Q000009:adverse effects; D015519:Bone Density; D016723:Bone Remodeling; D004311:Double-Blind Method; D012968:Etidronic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D005260:Female; D005269:Femur; D005272:Femur Neck; D050723:Fractures, Bone / Q000453:epidemiology; D006801:Humans; D008159:Lumbar Vertebrae; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy*; D000068296:Risedronic Acid; D016896:Treatment Outcome
chemical_list: D000068296:Risedronic Acid; D012968:Etidronic Acid; D019386:Alendronate