Alendronate improves QOL of postmenopausal women with osteoporosis
Hisaya Kawate1, Keizo Ohnaka2, Masahiro Adachi1, Suminori Kono3, Hideyuki Ikematsu4, Hisashi Matsuo5, Kazumi Higuchi6, Takehiko Takayama7, Ryoichi Takayanagi1
1Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; 2Department of Geriatric Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; 3Department of Preventive Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan; 4Internal Medicine, Haradoi Hospital, Fukuoka, Japan; 5Matsuo Naika Hospital, Fukuoka, Japan; 6Fukuoka Teishin Hospital, Fukuoka, Japan; 7Takayama Icho-ka and Naika Clinic, Fukuoka, Japan
Purpose: Postmenopausal osteoporosis causes bone fracture as well as pain, physical, psychological and socially adverse effects, which affects a patient’s quality of life (QOL). The effect of alendronate on QOL was investigated compared with that of alfacalcidol in postmenopausal osteoporotic women.
Patients and methods: A total of 44 postmenopausal osteoporotic women (mean age 69.8 years) with back or joint pain, although capable of walking, were randomly assigned to two groups; group A (n = 25) received 5 mg/day of alendronate, and group B (n = 19) received 0.5 μg/day of alfacalcidol, for the first 4 months. For the following 2 months, the group A received 0.5 μg/day of alfacalcidol and the group B received 5 mg/day of alendronate in a crossover design. The patient’s QOL was evaluated by score of Japanese Osteoporosis Quality of Life Questionnaire (JOQOL), and pain intensity using a visual analog scale (VAS). Bone metabolism was measured by bone mineral density (BMD) and a biomarker for bone resorption, urinary crosslinked N-terminal telopeptide of type I collagen (NTX).
Results: With 4-month treatment, alendronate, but not alfacalcidol, improved pain-related QOL, reduced joint pain by VAS, and increased bone mineral density. Both treatments significantly reduced bone resorption, the inhibition was significantly higher with alendronate (−56.5%) compared with alfacalcidol (−18.1%). After crossover, the patients in group A received alfacalcidol and had a reduced total and daily living activity-related QOL scores, and increased upper back pain by VAS. The group B received alendronate had significantly reduced bone resorption after the 2 months.
Conclusion: Alendronate improves the QOL of Japanese postmenopausal women with osteoporosis by reducing pain intensity as well as increasing bone mineral density.
Keywords: osteoporosis, bisphosphonates, quality of life, pain, vitamin D
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