Alendronate Reduces Bone Resorption in HIV-Associated Osteopenia/Osteoporosis
- 1 October 2004
- journal article
- clinical trial
- Published by Taylor & Francis Ltd in HIV Research & Clinical Practice
- Vol. 5 (5), 269-277
- https://doi.org/10.1310/md8v-5dlg-en3t-brhx
Abstract
Purpose: To evaluate the effects of alendronate, vitamin D, and calcium supplementation on bone metabolism and bone mineral density (BMD) in both HIV-infected men and women treated with highly active antiretroviral therapy (HAART). Method: We performed a 52-week prospective, multicenter, randomized, open-label clinical trial. Eligible participants were on stable HAART and had BMD values at the femoral neck or lumbar spine that corresponded to a t score less than -1. Patients were randomized to receive alendronate 70 mg weekly or no alendronate; calcium 1000 mg daily and vitamin D 500 IU daily were provided to all study recipients. Primary endpoint of the study was the change in bone metabolism evaluated by N-telopeptide of type 1 collagen and bone-specific alkaline phosphatase; the secondary endpoint was BMD variation. Results: 18 patients were randomized to the alendronate and 23 to the no-alendronate group (controls). The alendronate-treatment group compared to controls had a significant decrease in serum N-telopeptides, 1914 ± 1433.4 vs. 3967 ± 1650.5 pM/L (p = .005) after 1 year. Lumbar spine BMD increased by 4% in the alendronate group (p = .004) vs. 3.7% (p = .062) in controls, compared to baseline values. Femoral neck BMD decreased by 0.5% in the alendronate group (p = .05) and by 3.5% in the control group (p = .04). No between-groups differences for BMD were found (Δ lumbar-BMD 0.0351 ± 0.0406 in cases and 0.0356 ± 0.073 in controls [p = .977], Δ femoral-BMD –0.085 ± 0.160 in cases and –0.100 ± 0.165 in controls [p = .795]). Conclusion: Alendronate plus vitamin D and calcium was effective in reducing bone resorption. Alendronate improved lumbar BMD and minimized femoral BMD decrease after 52 weeks compared to treatment with vitamin D and calcium alone in patients on HAART with osteopenia/osteoporosis.Keywords
This publication has 31 references indexed in Scilit:
- Osteoporosis Prevention, Diagnosis, and TherapyJama-Journal Of The American Medical Association, 2001
- Changes in calciotropic hormones and biochemical markers of bone metabolism in patients with human immunodeficiency virus infectionMetabolism, 2000
- Serum type I collagen breakdown product (serum CTX) predicts hip fracture risk in elderly women:: The EPIDOS studyBone, 2000
- Effect of Alendronate on Risk of Fracture in Women With Low Bone Density but Without Vertebral FracturesResults From the Fracture Intervention TrialJama-Journal Of The American Medical Association, 1998
- Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fracturesThe Lancet, 1996
- Effect of Oral Alendronate on Bone Mineral Density and the Incidence of Fractures in Postmenopausal OsteoporosisThe New England Journal of Medicine, 1995
- Bone remodelling in human immunodeficiency virus-1-infected patients. A histomorphometric studyBone, 1995
- Alterations in bone turnover in HIV-positive patientsInfection, 1993
- Consensus development conference: Diagnosis, prophylaxis, and treatment of osteoporosisAmerican Journal Of Medicine, 1993
- Infection of human fibroblasts and osteoblast-like cells with HIV-1AIDS, 1990