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Continuous and cyclical clodronate therapies and bone density in postmenopausal bone loss
S Giannini1, A D'Angelo, L Sartori
1Institute of Internal Medicine, University of Padova, Italy.
Obstetrics and Gynecology
|September 1, 1996
Summary
Clodronate treatment in postmenopausal women with osteoporosis increased bone mass, particularly in the spine. A cyclical regimen of clodronate offered comparable spinal bone density benefits to continuous treatment, suggesting optimal bone turnover.
Area of Science:
- Endocrinology
- Bone Metabolism
- Pharmacology
Background:
- Postmenopausal osteoporosis is characterized by bone loss, increasing fracture risk.
- Bisphosphonates are a key therapeutic class for managing osteoporosis.
Purpose of the Study:
- To compare the efficacy of different oral clodronate administration regimens in postmenopausal women with osteoporosis.
- To assess the impact of clodronate on bone mineral density and bone turnover markers.
Main Methods:
- A randomized study involving 60 postmenopausal women with osteoporosis.
- Three treatment groups: calcium alone, continuous oral clodronate with calcium, and cyclical oral clodronate with calcium.
- Bone mineral density and biochemical markers of bone turnover were monitored over 12 months.
Main Results:
- Calcium alone led to a significant decline in spinal and femoral bone mass.
- Both clodronate regimens increased lumbar bone mass compared to calcium alone.
- Cyclical clodronate treatment resulted in higher spinal bone mass than continuous treatment at 12 months.
- Continuous clodronate significantly reduced bone resorption markers and osteocalcin levels.
Conclusions:
- One-year oral clodronate treatment effectively increases bone mass in postmenopausal osteoporosis, especially in the spine.
- Cyclical clodronate administration provides comparable spinal bone density benefits to continuous therapy.
- The continuous regimen may lead to excessive suppression of bone turnover, limiting further gains.