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IOF World Congress News Prediction of future hip, non-spine and vertebral fractures
shown in the Fracture Intervention Trial Dr. Douglas Bauer of the University of California at San Francisco and colleagues examined the association between changes in biochemical measures of bone remodeling and the reduction in non-vertebral fractures in the Fracture Intervention Trial (FIT). The study, announced at the IOF World Congress on Osteoporosis, included more than 6,000 U.S. women with low bone mass and found that there were fewer fractures in women with greater reductions in bone markers. Non-spine fractures were reduced by 11%; spine fractures were reduced by 26% and hip fractures were reduced by 39%. This trial, the largest one of its kind ever conducted, assessed the effects of treatment with alendronate on bone mineral density as well as several biochemical markers of bone turnover, including bone-specific alkaline phosphatase (BAP), C-terminal telopeptide (CTX) and terminal propeptide (P1NP). Measurements were taken at baseline and after one year of treatment with alendronate (5 mg/day) or placebo. A total of 6,086 women were included in the study, who suffered a total of 72 hip and 786 non-spinal fractures over the 3.6-year mean follow-up period. In addition, 336 women were shown to have suffered incident vertebral fractures. An assessment of fracture risk in the placebo group indicated that there was no association between bone turnover markers or bone mineral density measurements and risk of hip, non-spine or vertebral fractures. However, among patients in the alendronate treatment group, the risk of fracture was reduced to the greatest degree among those women showing the largest reductions in bone turnover markers. "This study confirms the importance of bone turnover and suggests that biochemical markers may indeed be useful to help develop new treatments," said Bauer. Alendronate is a potent bone resorption inhibitor that acts by inhibiting the bone-eroding activity of osteoclasts. Evidence from a large database of clinical trials and post-marketing surveillance studies has confirmed that alendronate does not have deleterious effects on bone quality, as it does not interfere with the process of new bone formation.
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