Etidronate and alendronate in the treatment of postmenopausal osteoporosis

被引:14
作者
Beauchesne, MF
Miller, PF
机构
[1] Hop Sacre Coeur, Dept Pharm, Montreal, PQ H4J 1C5, Canada
[2] Univ Montreal, Fac Pharm, Montreal, PQ H3C 3J7, Canada
[3] Univ British Columbia, Fac Med, Fac Pharmaceut Sci, Vancouver, BC, Canada
[4] Univ British Columbia, Fac Med, Dept Family Practice, Vancouver, BC, Canada
关键词
postmenopausal osteoporosis; bisphosphonates; etidronate; alendronate;
D O I
10.1345/aph.18212
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
OBJECTIVE: To review the clinical trials evaluating the efficacy of etidronate and alendronate in the treatment of established postmenopausal osteoporosis. DATA SOURCE: A MEDLINE search was performed (from 1966 through September 1998) using the search terms bisphosphonates, etidronate, alendronate, and postmenopausal osteoporosis. English language articles were considered for review. STUDY SELECTION AND DATA EXTRACTION: prospective, randomized, double-blind, placebo-controlled clinical trials using fracture as an end point were selected to review the efficacy of etidronate and alendronate in the treatment of postmenopausal osteoporosis. Results for the outcomes of bone mineral density (BMD) and fracture are summarized. DATA SYNTHESIS: Etidronate and alendronate increase spinal BMD in postmenopausal women with osteoporosis. In one study, etidronate decreased the number of women sustaining new radiographic vertebral fractures over two years, but this effect was lost after three yeats of treatment. Alendronate reduces the number of radiographic vertebral fractures in postmenopausal women with a low bone mass. In women with preexisting fractures, alendronate decreases the number of patients with radiographic vertebral fractures, clinical (i.e., symptomatic vertebral and nonvertebral) fractures, and hip fractures. A significant reduction in the overall number of nonvertebral fractures has not been demonstrated in clinical trials evaluating either alendronate or etidronate. CONCLUSIONS: No studies have directly compared the efficacy of alendronate and etidronate and the results of long-term clinical trials (i.e., >5 y) have not been published. Based on the results obtained in clinical trials using fracture as an end point, alendronate appears to be the bisphosphonate of choice. Safety profiles and cost should also be considered in the choice of etidronate or alendronate for the treatment of postmenopausal osteoporosis.
引用
收藏
页码:587 / 599
页数:13
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