Characteristics Associated with Bone Mineral Density Responses to Alendronate in Men
Identifieur interne : 004547 ( Ncbi/Curation ); précédent : 004546; suivant : 004548Characteristics Associated with Bone Mineral Density Responses to Alendronate in Men
Auteurs : Erik D. Swenson [États-Unis] ; Karen E. Hansen ; Andrea N. Jones ; Zhanhai Li ; Brooke Baltz [États-Unis] ; Arthur A. Schuna ; Mary E. ElliottSource :
- Calcified tissue international [ 0171-967X ] ; 2013.
Abstract
Some patients experience reduced bone mineral density (BMD) despite bisphosphonate therapy. We performed a retrospective chart review study to detect factors associated with decreased BMD in men prescribed alendronate.
Two investigators reviewed eligible medical records and used a standardized form to record potential characteristics predicting men’s response to alendronate. We analyzed patient characteristics associated with annualized change in hip and spine BMD (D-BMD).
Among 115 eligible men, 19 (17%) experienced significantly decreased BMD at the hip or spine, defined as a change exceeding precision error. Eleven men (10%) fractured during therapy. Spine D-BMD was positively associated with adherence to alendronate (R = 0.23, p=0.02) and inversely associated with baseline body weight (R = −0.21, p=0.03). Hip D-BMD was positively associated with annualized weight change (R = 0.19, p=0.0498) and negatively associated with patient age and number of concomitant medications (R = −0.21, p=0.03; R = −0.20, p = 0.03, respectively). In stepwise linear models, spine D-BMD was positively associated with alendronate adherence and multivitamin use, and negatively with baseline body weight. Hip D-BMD was negatively associated with age. Fracture during treatment was associated with fracture prior to therapy (p=0.03)
In this small study of men prescribed alendronate, BMD response showed a positive association with adherence to therapy, weight gain, and use of a multivitamin. By contrast, older age, higher baseline body weight, and higher number of medications were each associated with a decrease in BMD. Larger studies are needed to confirm and extend these findings.
Url:
DOI: 10.1007/s00223-013-9715-9
PubMed: 23494407
PubMed Central: 4560467
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<author><name sortKey="Swenson, Erik D" sort="Swenson, Erik D" uniqKey="Swenson E" first="Erik D." last="Swenson">Erik D. Swenson</name>
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<author><name sortKey="Hansen, Karen E" sort="Hansen, Karen E" uniqKey="Hansen K" first="Karen E." last="Hansen">Karen E. Hansen</name>
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<author><name sortKey="Jones, Andrea N" sort="Jones, Andrea N" uniqKey="Jones A" first="Andrea N." last="Jones">Andrea N. Jones</name>
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<author><name sortKey="Li, Zhanhai" sort="Li, Zhanhai" uniqKey="Li Z" first="Zhanhai" last="Li">Zhanhai Li</name>
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<author><name sortKey="Baltz, Brooke" sort="Baltz, Brooke" uniqKey="Baltz B" first="Brooke" last="Baltz">Brooke Baltz</name>
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<author><name sortKey="Schuna, Arthur A" sort="Schuna, Arthur A" uniqKey="Schuna A" first="Arthur A." last="Schuna">Arthur A. Schuna</name>
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<author><name sortKey="Hansen, Karen E" sort="Hansen, Karen E" uniqKey="Hansen K" first="Karen E." last="Hansen">Karen E. Hansen</name>
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<author><name sortKey="Jones, Andrea N" sort="Jones, Andrea N" uniqKey="Jones A" first="Andrea N." last="Jones">Andrea N. Jones</name>
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<author><name sortKey="Li, Zhanhai" sort="Li, Zhanhai" uniqKey="Li Z" first="Zhanhai" last="Li">Zhanhai Li</name>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">Some patients experience reduced bone mineral density (BMD) despite bisphosphonate therapy. We performed a retrospective chart review study to detect factors associated with decreased BMD in men prescribed alendronate.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">Two investigators reviewed eligible medical records and used a standardized form to record potential characteristics predicting men’s response to alendronate. We analyzed patient characteristics associated with annualized change in hip and spine BMD (D-BMD).</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Among 115 eligible men, 19 (17%) experienced significantly decreased BMD at the hip or spine, defined as a change exceeding precision error. Eleven men (10%) fractured during therapy. Spine D-BMD was positively associated with adherence to alendronate (R = 0.23, p=0.02) and inversely associated with baseline body weight (R = −0.21, p=0.03). Hip D-BMD was positively associated with annualized weight change (R = 0.19, p=0.0498) and negatively associated with patient age and number of concomitant medications (R = −0.21, p=0.03; R = −0.20, p = 0.03, respectively). In stepwise linear models, spine D-BMD was positively associated with alendronate adherence and multivitamin use, and negatively with baseline body weight. Hip D-BMD was negatively associated with age. Fracture during treatment was associated with fracture prior to therapy (p=0.03)</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">In this small study of men prescribed alendronate, BMD response showed a positive association with adherence to therapy, weight gain, and use of a multivitamin. By contrast, older age, higher baseline body weight, and higher number of medications were each associated with a decrease in BMD. Larger studies are needed to confirm and extend these findings.</p>
</sec>
</div>
</front>
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