Effect of alendronate in elderly patients after low trauma hip fracture repair

Osteoporos Int. 2008 Oct 28. [Epub ahead of print] Cecilia D, Jódar E, Fernández C, Resines C, Hawkins F.

One year of once weekly alendronate, when given shortly after the surgical repair of a hip fracture, produces reductions in bone markers and increases proximal femoral bone density. The therapy was well tolerated. INTRODUCTION: Hip fracture is the most devastating type of osteoporotic fracture and increases notably the risk of subsequent fractures. The aim of this paper was to evaluate the effects of 1 year therapy with a weekly dose of alendronate in the bone mineral density and bone markers in elderly patients after low trauma hip fracture repair. METHODS: Two hundred thirty-nine patients (81 +/- 7 years; 79.8% women) were randomized to be treated either with calcium (500 mg/daily) and vitamin D(3) (400 IU/daily; Ca-Vit D group) or with alendronate (ALN, 70 mg/week) plus calcium and vitamin D(3) (500 mg/daily and 400 IU/daily, respectively; ALN + Ca-Vit D group). RESULTS: One hundred forty-seven (61.5%) patients completed the trial. Alendronate increased proximal femoral bone mineral density (BMD) in the intention-to-treat analysis (mean difference (95% confidence interval); total hip 2.57% (0.67; 4.47); trochanteric 2.96% (0.71; 5.20), intertrochanteric 2.32% (0.36; 4.29)), but the differences were not significant in the BMD of the femoral neck (0.47%; (-2.03; 2.96) and the lumbar spine (0.69%; (-0.86; 2.23)). Bone turnover markers decreased during alendronate treatment. CONCLUSION: The present study demonstrates for the first time the anti-resorptive efficacy of alendronate given immediately after surgical repair in an elderly population with recent hip fracture. This effect should positively affect the rate of subsequent fractures.