OP0113 Increases in bone mineral density explain the reduction in incidence of nonvertebral fractures seen with antiresorptive therapy in women with postmenopausal osteoporosis

RD Wasnich, MC Hochberg, S Greenspan, PD Ross, PD Miller
2001 Speaker abstracts 2001   unpublished
Methods In a controlled, prospective, comparative two-arm study we treated 105 patients with established CIO (average age 65 years) over three years with either 2 mg ibandronate every 3 months iv (group A) or with a daily dose of 1 mg alfacalcidol orally (group B). All patients received a 500 mg calcium supplement per day. The patients had been on CS for an average time of 8 years. The initial mean BMD values were very low (T-score lumbar spine -3.8, femoral neck -3.1). 91% of the patients had
more » ... or more prevalent vertebral fractures (average: 3.8 fractures/ patient). Results During the 36 months of observation there was a progressive reduction in back pain in both groups. No relevant adverse events were recorded. Mean BMD at the lumbar spine increased by 14.2% in the ibandronate cases and 2.3% in the 1alpha group (p < 0.0001). The corresponding changes after 3 years for the femoral neck were 5.1% and 1.6% (p = 0.0005). Six new vertebral fractures per 6 patients were observed in group A and 15 per 12 patients in group B. Conclusion We conclude that ibandronate is superior to alfacalcidol in the treatment of CIO. The data confirm the very positive effect of BP therapy on the course of CIO. The very good acceptance and excellent compliance with the 3 months bolus therapy in our trial, the scarcity of adverse events and the avoidance of poor intestinal absorption make ibandronate a very interesting alternative to oral BP treatment. Background There have been few studies of physical impairment following nonspine fractures. Objectives To examine this issue among 705 Japanese women in Hawaii. Methods Only new fractures that had occurred during 13 years of follow up were considered; 121 women had 1, and 26 women had 2 or more new nonviolent, nonspine fractures. Activities of daily living (ADLs) and measures of physical performance (PP) were measured at the end of follow up. Associations with new nonspine fractures were evaluated using logistic regression analysis adjusted for age, height, body mass index, prior vertebral fractures, and prior nonspine fractures. Results Women with new fractures had significantly greater difficulty with 10 out of 13 ADLs, with odds ratios of 1.6 to 2.9. The associations tended to be stronger for fractures within the prior 5 years; only 2 ADLs were significantly associated with fractures that had occurred more than 5 years earlier. For most ADLs, associations with hip, rib, and upper arm fractures were generally stronger (odd ratios >2.3) than for wrist, foot, or lower leg fractures (odds ratios < 2.0). Overall, nonspine fractures were significantly associated with 25% slower walking speed and longer time to complete the chair stand test, but not
doi:10.1136/annrheumdis-2001.634 fatcat:inzfzvu76vexzdodv4wt4oxkrq