Comparison of effects of alendronate and raloxifene on lumbar bone mineral density, bone turnover, and lipid metabolism in elderly women with osteoporosis.
OBJECTIVE
To compare the effects of alendronate and raloxifene on lumbar bone mineral density (BMD), bone turnover, and lipid metabolism in elderly women with osteoporosis.


METHODS
One hundred twenty-two postmenopausal women with osteoporosis (mean age: 69.4 years) were randomly divided into 2 groups of 61 patients: the alendronate group and the raloxifene group. BMD of the lumbar spine, urinary level of cross-linked N-terminal telopeptides of type I collagen (NTX), and serum levels of alkaline phosphatase (ALP), total cholesterol (TC), high and low density lipoprotein cholesterols (LDL-C and HDL-C, respectively), and triglycerides (TG) were measured during the 12-month-treatment period.


RESULTS
The trial in 50 patients in the alendronate group and 52 patients in the raloxifene group could be completed. Both alendronate and raloxifene increased lumbar BMD (+8.0% and +2.4% at 12 months, respectively), followed by reductions of urinary NTX level and serum ALP level; however, the effects of alendronate were more pronounced than those of raloxifene. Only raloxifene reduced the serum levels of TC and LDL-C (-3.9% and -7.7% at 12 months, respectively), without any significant effect on the serum HDL-C and TG levels.


CONCLUSIONS
The present study confirmed the efficacy of alendronate greater than raloxifene in increasing lumbar BMD through its effect on marked reduction of the bone turnover more than by raloxifene, and some beneficial effects of raloxifene on lipid metabolism in elderly women with osteoporosis.
Iwamoto
Jun
J
Department of Sports Medicine, Keio University School of Medicine, 35 Shinano-machi, Tokyo 160-8582, Japan. jiwamoto@sc.itc.keio.ac.jp
Sato
Yoshihiro
Y
Uzawa
Mitsuyoshi
M
Takeda
Tsuyoshi
T
Matsumoto
Hideo
H
D000368:Aged; D019386:Alendronate / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000187:drug effects*; D002118:Calcium / Q000097:blood; D005260:Female; D050723:Fractures, Bone / Q000517:prevention & control; D006801:Humans; D050356:Lipid Metabolism / Q000187:drug effects*; D010024:Osteoporosis / Q000188:drug therapy* / Q000378:metabolism*; D010758:Phosphorus / Q000097:blood; D020849:Raloxifene Hydrochloride / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D013131:Spine / Q000187:drug effects
D015415:Biomarkers; D010758:Phosphorus; D020849:Raloxifene Hydrochloride; D002118:Calcium; D019386:Alendronate