title: Alendronate treatment for hip osteoarthritis: prospective randomized 2-year trial.
abstract: We examined the clinical efficacy of alendronate treatment for hip osteoarthritis using multiple outcome measures. Fifty patients with symptomatic hip osteoarthritis were enrolled in this prospective trial. The patients were randomly assigned to an alendronate group (35 mg/week alendronate and 600 mg/day calcium lactate) or a control group (600 mg/day calcium lactate) for 2 years. The groups were compared with regard to the following five parameters. The primary outcome measures are the following: (1) the Western Ontario and McMaster Universities (WOMAC) osteoarthritis pain score and the visual analog score (VAS). The secondary outcome measures are the following: (2) joint space width (JSW) measured on radiographs using a semiautomatic computer software, (3) the biochemical markers urinary N-telopeptide of type I collagen (NTX-I) and C-terminal cross-linking telopeptide of type II collagen (CTX-II), (4) dual-energy X-ray absorptiometry of the hip and lumbar spine, and (5) bone marrow edema on magnetic resonance images. The alendronate group showed pain improvement trends in VAS and WOMAC scores, whereas the control group showed worsening of pain. The alendronate group showed significant improvement in WOMAC pain scores after 12 months (p = 0.031) but no significant prevention of structural osteoarthritis progression, defined as a decrease in JSW >0.30 mm or conversion to total hip arthroplasty. There was significantly larger decrease in the biochemical markers and significantly increased bone density in the alendronate group. Alendronate treatment by standard dose for osteoporosis showed clinical efficacy for decreasing pain but failed to show preventive effects for structural progression of hip osteoarthritis.
authors.affiliation: Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan, nishii@rf7.so-net.ne.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nishii
authors.forename: Satoru
authors.initials: S
authors.lastname: Tamura
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Shiomi
authors.forename: Hideki
authors.initials: H
authors.lastname: Yoshikawa
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Sugano
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D019386:Alendronate / Q000008:administration & dosage*; D019644:Arthroplasty, Replacement, Hip; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000008:administration & dosage; D017610:Calcium Compounds / Q000008:administration & dosage*; D024042:Collagen Type I / Q000097:blood; D024043:Collagen Type II / Q000097:blood; D004164:Diphosphonates / Q000008:administration & dosage; D018450:Disease Progression; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007773:Lactates / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000188:drug therapy*; D010146:Pain; D010147:Pain Measurement; D010446:Peptide Fragments / Q000097:blood; D010455:Peptides / Q000097:blood; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents; C000590554:C-terminal cross-linking telopeptide of type II collagen, human; D017610:Calcium Compounds; D024042:Collagen Type I; D024043:Collagen Type II; D004164:Diphosphonates; D007773:Lactates; D010446:Peptide Fragments; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; C110051:calcium lactate; D019386:Alendronate