Related Experiment Videos
Alendronate in primary hyperparathyroidism: a double-blind, randomized, placebo-controlled trial
Aliya A Khan1, John P Bilezikian, Annie W C Kung
1McMaster University, 331-209 Sheddon Avenue, Oakville, Ontario, Canada L6J 1X8. avkhan@aol.com
The Journal of Clinical Endocrinology and Metabolism
|July 9, 2004
Summary
Alendronate significantly improves bone mineral density (BMD) in patients with primary hyperparathyroidism (PHPT). This study shows alendronate increases BMD and reduces bone turnover markers, offering a potential alternative to surgery for PHPT.
Area of Science:
- Endocrinology
- Bone Metabolism
- Pharmacology
Background:
- Primary hyperparathyroidism (PHPT) is frequently linked to diminished bone mineral density (BMD).
- Asymptomatic PHPT patients not meeting surgical criteria or refusing surgery represent a population for conservative management studies.
- Evaluating bisphosphonates like alendronate (ALN) is crucial for managing bone loss in PHPT.
Purpose of the Study:
- To assess the efficacy of daily alendronate (10 mg) in maintaining or improving BMD in patients with PHPT.
- To evaluate the impact of alendronate on bone turnover markers in PHPT patients.
- To determine if alendronate offers a viable alternative to parathyroidectomy for asymptomatic PHPT with low BMD.
Main Methods:
- A 2-year, randomized, double-blind, placebo-controlled trial involving 44 patients with asymptomatic PHPT.
- Patients received either placebo or alendronate (10 mg daily), with a crossover to alendronate at 12 months for the placebo group.
- BMD was measured every 6 months (dual-energy x-ray absorptiometry); biochemical markers (calcium, PTH, BSAP, NTX) were monitored every 3 months.
Main Results:
- Alendronate treatment led to significant increases in lumbar spine BMD (6.85%) and total hip BMD (4.01%) after 12 months, sustained over 24 months.
- Femoral neck BMD also showed a significant gain (3.67%) at 24 months.
- Alendronate markedly reduced bone turnover markers, with a 66% decrease in urinary NTX and significant reductions in BSAP, while serum calcium and PTH remained stable.
Conclusions:
- Alendronate significantly increases BMD at key skeletal sites in patients with PHPT.
- The drug effectively reduces markers of bone turnover without altering calcium or PTH levels.
- Alendronate presents a potentially valuable therapeutic option for managing asymptomatic PHPT, particularly in individuals with low BMD, as an alternative to surgical intervention.