Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Data show bone mineral density explains only small portion of nonvertebral fracture risk reduction

20.06.2003


A new analysis showed that increases in bone mineral density (BMD) only accounted for 6 to 12 percent of the reduction in non-vertebral fracture risk that resulted from osteoporosis treatment over three years in postmenopausal women.

Previously, analyses of clinical trial data for three major osteoporosis therapies have shown that increases in BMD account for only a fraction (<1/3) of the total reduction in vertebral fracture risk. These new findings, presented today at ENDO 2003, the 85th annual meeting of The Endocrine Society, support that this is also the case for fractures at nonvertebral sites, such as the hip and wrist.

BMD measurement remains a good tool for evaluating patients who are not on treatment and for identifying patients on treatment who are not responding; however, BMD increases in response to therapy cannot replace fracture reduction as the ultimate goal of osteoporosis therapies and the most clinically relevant endpoint. Although BMD is often used as a surrogate marker of efficacy, this study provides further confirmation that BMD is only one of many factors that contribute to the efficacy of an osteoporosis therapy. "These results underscore the importance of physicians evaluating osteoporosis therapies based upon fracture reduction data," said Nelson B. Watts, MD, presenting author and Director, University of Cincinnati Bone Health and Osteoporosis Center. "Many factors of bone quality are important for strong bones, such as rate of bone turnover, bone microarchitecture, and material properties of bone. Therefore, BMD should not be used to compare fracture efficacy between osteoporosis therapies."



Analysis Details

This analysis was conducted with data from two pivotal trials that supported the approval of ActonelŽ(risedronate sodium tablets) for the prevention and treatment of postmenopausal osteoporosis. The trials included over 3,600 women who were enrolled on the basis of low lumbar spine BMD (T-score < -2.0) and at least one prevalent vertebral fracture OR at least two prevalent vertebral fractures. Patients were randomized to receive either Actonel 5 mg daily or placebo. All patients received 1,000 mg daily calcium, and, if baseline levels were low, up to 500 IU daily vitamin D. Nonvertebral fractures were defined as a composite endpoint from fractures of the clavicle, upper arm, forearm, pelvis, hip, and lower leg.

The reduction in nonvertebral fracture risk in the Actonel patients was estimated to be 35 percent over 3 years. The average increase in BMD for these patients was 4.6 percent at lumbar spine and 2.6 percent at femoral neck. The BMD increases at the lumbar spine accounted for only 12.2 percent of the nonvertebral fracture risk reduction, and the BMD increases at the femoral neck accounted for only 5.5 percent of the nonvertebral fracture risk reduction.

About Osteoporosis

Osteoporosis is a skeletal disorder characterized by reduced bone strength predisposing a person to an increased risk of fracture. According to the National Osteoporosis Foundation, 1.2 million women suffer osteoporotic fractures in the U.S. each year. Risk factors for osteoporosis and subsequent fractures include loss of estrogen production, advanced age, preexisting fractures, and low bone mineral density. Studies show that among postmenopausal women with osteoporosis who experience a spinal fracture, one out of five will suffer their next spinal fracture within just one year, potentially leading to a fracture cascade.

Preventive measures, such as not smoking, maintaining a balanced diet supplemented with calcium and vitamin D, and engaging in weight-bearing exercise like walking, can reduce an individual’s chances of developing osteoporosis. However, in some people these preventive measures may not be enough, and medications like Actonel may be beneficial.

About ActonelŽ (risedronate sodium tablets)

Actonel was developed by Procter & Gamble Pharmaceuticals and is co-marketed by Procter & Gamble Pharmaceuticals and Aventis Pharmaceuticals. Actonel 35 mg Once-a-Week and Actonel 5 mg daily are indicated for the prevention and treatment of osteoporosis in postmenopausal women. Actonel 5 mg daily is also indicated for the prevention and treatment of glucocorticoid-induced osteoporosis (GIO) in men and women either initiating or continuing systemic glucocorticoid treatment (greater than or equal to 7.5 mg/d prednisone or equivalent) for chronic diseases.

In clinical trials, Actonel was generally well tolerated. Actonel is contraindicated in patients with hypocalcemia, known hypersensitivity to any component of this product, or inability to stand or sit upright for at least 30 minutes. Hypocalcemia and other disturbances of bone and mineral metabolism should be effectively treated before starting Actonel therapy. Actonel is not recommended for use in patients with severe renal impairment (creatinine clearance < 30 mL/min).

Bisphosphonates may cause upper gastrointestinal disorders such as dysphagia, esophagitis and esophageal or gastric ulcer. Patients should pay particular attention to the dosing instructions, as failure to take the drug according to instructions may compromise clinical benefits and may increase the risk of adverse events.

In clinical trials, the overall incidence of adverse events with Actonel 5 mg daily was comparable to placebo. The most commonly reported adverse events regardless of causality were infection (primarily upper respiratory, placebo 29.7 percent vs. Actonel 5 mg 29.9 percent), back pain (23.6 percent vs. 26.1 percent), and arthralgia (21.1 percent vs. 23.7 percent).

In a one-year clinical trial comparing Actonel 35 mg Once-a-Week and Actonel 5 mg daily, the overall incidence of adverse events with the two dosing regimens was similar. The most commonly reported adverse events regardless of causality were infection (Actonel 35 mg 20.6 percent vs. Actonel 5 mg 19.0 percent), arthralgia (14.2 percent vs. 11.5 percent) and constipation (12.2 percent vs. 12.5 percent).

Contact: Molly Fahner, molly.fahner@hillandknowlton.com

Molly Fahner | EurekAlert!
Further information:
http://www.actonel.com
http://www.hillandknowlton.com

More articles from Health and Medicine:

nachricht A 'half-hearted' solution to one-sided heart failure
24.11.2017 | Boston Children's Hospital

nachricht New study points the way to therapy for rare cancer that targets the young
22.11.2017 | Rockefeller University

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: New proton record: Researchers measure magnetic moment with greatest possible precision

High-precision measurement of the g-factor eleven times more precise than before / Results indicate a strong similarity between protons and antiprotons

The magnetic moment of an individual proton is inconceivably small, but can still be quantified. The basis for undertaking this measurement was laid over ten...

Im Focus: Frictional Heat Powers Hydrothermal Activity on Enceladus

Computer simulation shows how the icy moon heats water in a porous rock core

Heat from the friction of rocks caused by tidal forces could be the “engine” for the hydrothermal activity on Saturn's moon Enceladus. This presupposes that...

Im Focus: Nanoparticles help with malaria diagnosis – new rapid test in development

The WHO reports an estimated 429,000 malaria deaths each year. The disease mostly affects tropical and subtropical regions and in particular the African continent. The Fraunhofer Institute for Silicate Research ISC teamed up with the Fraunhofer Institute for Molecular Biology and Applied Ecology IME and the Institute of Tropical Medicine at the University of Tübingen for a new test method to detect malaria parasites in blood. The idea of the research project “NanoFRET” is to develop a highly sensitive and reliable rapid diagnostic test so that patient treatment can begin as early as possible.

Malaria is caused by parasites transmitted by mosquito bite. The most dangerous form of malaria is malaria tropica. Left untreated, it is fatal in most cases....

Im Focus: A “cosmic snake” reveals the structure of remote galaxies

The formation of stars in distant galaxies is still largely unexplored. For the first time, astron-omers at the University of Geneva have now been able to closely observe a star system six billion light-years away. In doing so, they are confirming earlier simulations made by the University of Zurich. One special effect is made possible by the multiple reflections of images that run through the cosmos like a snake.

Today, astronomers have a pretty accurate idea of how stars were formed in the recent cosmic past. But do these laws also apply to older galaxies? For around a...

Im Focus: Visual intelligence is not the same as IQ

Just because someone is smart and well-motivated doesn't mean he or she can learn the visual skills needed to excel at tasks like matching fingerprints, interpreting medical X-rays, keeping track of aircraft on radar displays or forensic face matching.

That is the implication of a new study which shows for the first time that there is a broad range of differences in people's visual ability and that these...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Ecology Across Borders: International conference brings together 1,500 ecologists

15.11.2017 | Event News

Road into laboratory: Users discuss biaxial fatigue-testing for car and truck wheel

15.11.2017 | Event News

#Berlin5GWeek: The right network for Industry 4.0

30.10.2017 | Event News

 
Latest News

IceCube experiment finds Earth can block high-energy particles from nuclear reactions

24.11.2017 | Physics and Astronomy

A 'half-hearted' solution to one-sided heart failure

24.11.2017 | Health and Medicine

Heidelberg Researchers Study Unique Underwater Stalactites

24.11.2017 | Earth Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>