Three-year outcome of alendronate treatment in older Japanese women with osteoporosis

The effects of alendronate (ALN) treatment on the bone mineral density (BMD), bone turnover markers, and fracture incidence remain to be established in older Japanese patients. The aim of the present study was to compare the outcome of ALN treatment for 3 years among postmenopausal osteoporotic Japanese women <80 years of age and those ≥80 years of age. One hundred ninety-eight postmenopausal osteoporotic women who had been treated with ALN for more than 3 years were analyzed. The 3-year outcome was compared between women <80 years of age (control group, n=167) and those ≥80 years of age (older group, n=31). During the 3-year treatment period, the urinary cross-linked N-terminal telopeptides of the type I collagen and serum alkaline phosphatase levels significantly decreased and the lumbar spine BMD significantly increased, compared with the baseline values, in manners that were similar in the control and older groups. However, the incidence of non-vertebral fractures, but not of vertebral fractures, was significantly higher in the older group than in the control group (16.1% vs 3.0%). These results suggested that the incidence of non-vertebral fractures was significantly higher among postmenopausal osteoporotic Japanese women ≥80 years of age who were treated with ALN than among those <80 years of age despite the similar effect of ALN treatment on surrogate markers.