RESULTS AND EFFECTIVENESS PREDICTORS OF ALENDRONATETHERAPY IN POSTMENOPAUSAL PATIENTS WITH PRIMARYHYPERPARATHYROIDISM

Abstract


Primary hyperparathyroidism (PHPT) is a common disorder often associated with reduced bone mineral density (BMD) and osteoporosis. The main goal in treating patients who refuse surgery is the correction of bone complications.
The aim of this study is to evaluate safety and efficacy of alendronate treatment in patients with PHPT and osteoporosis. Eligible patients were postmenopausal women suffering from PHPT who did not meet surgical guidelines or ignored surgery due to different reasons. 55 osteoporotic or osteopenic women received alendronate 70 mg weekly and 43 were leaved under medical observation for the reasons of not being osteoporotic or financial unable to comply with treatment/
Results: After 2 years of treatment alendronate group showed statistically significant gain in BMD at L24 +4,0±4,2%, Neck +2,2±4,4%„ TH +2,3±4,5%. At the same time observational group showed decrease in BMD at L24 -4,2±4,0%, TH -3,5±3,8%, R33% -4,0±6,5%, [95% CI -7,6; -0,4]. On the whole BMD dynamics in groups differed at the following sites: L2 (p=0,00004), Neck (p=0,005), TH (p=0,001), R33% (p=0,006). '
Alendronate intake was accompanied by serum Ca decrease (at 1 year point -4,3±5,4%, p=0,00005, at 2 year -2,7±6,4%, p=0,04), 24 hours'Ca excretion decrease from (Me) 8,5 to 6,3 mmol/day at 1 year point, (p=0,007) without PTH elevation. As well as CTx fell at Me: 66% at 1 year and at 60% at 2 year point and OK at 39% and at 27%, correspondingly, p<0,01. In the observation group PTH, serum Ca were stable, 24 hours 'Ca excretion increased from 7,0 to 7,7 at 2 year, p=0,003, as well as CTx level that increased 53%, p=0,01 at 2 years.
Conclusions: alendronate treatment in postmenopausal women improves BMD in trabecular bone sites and prevents BMD decrease in cortical sites. At least 2 years of therapy is needed to get the significant increase BMD in cortical bone . All patients should be under medical control for timely revelation of disease progression.

About the authors

I I Dedov

A V Belyaeva

Email: anna_belyaeva@mail.ru

L Ya Rozhinskaya

N G Mokrysheva

S S Mirnaya

G S Kolesnikova

A V Il'in

N I Sazonova

T O Chernova

A M Artemova

I I Dedov

A. V. Belyaeva

L. Y. Rozhinskaya

N. G. Mokrysheva

S. S. Mirnaya

G. S. Kolesnikova

A. V. Ilyin

N. I. Sazonova

T. O. Chernova

A. M. Artemova

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Copyright (c) 2010 Dedov I.I., Belyaeva A.V., Rozhinskaya L.Y., Mokrysheva N.G., Mirnaya S.S., Kolesnikova G.S., Il'in A.V., Sazonova N.I., Chernova T.O., Artemova A.M., Dedov I.I., Belyaeva A.V., Rozhinskaya L.Y., Mokrysheva N.G., Mirnaya S.S., Kolesnikova G.S., Ilyin A.V., Sazonova N.I., Chernova T.O., Artemova A.M.

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