Endocrine Abstracts (2009) 20 P256

The change of bone mineral density in postmenopausal women treated by combined agent alendronate and alfacalcidol assessed by digital X-ray radiogrammetry

Corina Galesanu1, Natalia Lisnic1, Mihail-Romeo Galesanu2, Ciprian Ciubotariu1, Roxana-Gabriela Galesanu2, Rodica Vasilica3, Dan Radu3 & Dan Ursuleanu3

1Department of Endocrinology, University of Medicine and Pharmacy, Gr. T. Popa, Iasi, Romania; 2Department of Osteodensitometry, Centre of Imaging and Radiologic Diagnosis, Iasi, Romania; 3Department of Endocrinology, County Hospital, Botosani, Romania.

Hypovitaminosis D is frequent in population over 65 years age, producing a secondary hyperparathyroidism, increase the bone remodeling, bone loss and osteoporotic fractures, loss of the muscle force.

Daily dose of 0.5 μg alfacalcidol was effectively in improved muscle strength in elderly and reduced falls. The bisphosphonates have been shown to increase Bone Mineral Density (BMD) and reduce bone turnover in postmenopausal osteoporosis. The combined agent Bisphosphonates and Alfacalocidol can be an alternative treatment. We are proposed to evaluate the effect of combinat agent Alendronate (Fosamax®) and Alfacalcidol (Alpha D3®) on BMD changes in postmenopausal osteoporosis compared with Fosamax® only.

We studied 10 105 healthy women with ages between 20 and 89 years referred to our department of densitometry using Digital X-Ray Radiogrammetry – BMD (DXR-BMD), 7103 from them being in postmenopause; 830 from them presented osteoporosis (WHO criteria). Among 414 patients selected from Fosamax® - treatment 70 mg/week, 138 were under the treatment after 5 years or more. 104 women were treated with Fosamax® 70 mg/week and Alpha D3® 1 μg/daily. The mean age of osteoporotic treated women was 61.3±7.8 years.

BMD by DXR was measured at each 12 months. The BMD mean changes under Fosamax® was: +3.5% after 1 year; +4.6% after 2 years; +5.4% after 3 years; +6.3% after 4 years and +7.2% after 5 years. The BMD mean changes at the patients treated with Fosamax® and Alpha D3® was: +3.8% in the 1 year; +5.8% after 2 years; +6.7% after 3 years; +7.4% after 4 years and +8.3% after 5 years. Three patients (2.1%) suffered a fracture under Fosamax®. We conclude that BMD changed under the both treatments. The combined – treatment Fosamax® + Alpha D3® increased BMD significantly more that Fosamax® only. DXR-BMD is a good method for diagnosis and monitoring osteoporosis therapy.