Effects of alendronate sodium versus hormone replacement therapy for osteoporosis

Su Fan; Lin Jing-xia; Wu Li-qiu; Cai Dong-mei; Zhuang Ze

doi:10.3969/j.issn.2095-4344.2016.46.007

Abstract：BACKGROUND:Estrogen, bisphosphonates, and calcitonin have been shown to improve bone density and decrease fracture rate, among which, alendronate sodium is the most commonly used and gains extensive attention. OBJECTIVE:To compare the treatment outcomes of alendronate sodium and hormone replacement therapies for postmenopausal osteoporosis. METHODS:198 cases of postmenopausal osteoporosis were randomly divided into two groups (n=99 per group), and then respectively given the oral administration of alendronate sodium, 70 mg weekly, continuous for 1 year, and the oral treatment of tibolone tablets (hormone replacement therapy group), 2.5 mg/d, for 1 consecutive year. The bone density and sex hormone levels before and after treatment, the incidence of adverse reactions and the levels of bone turnover makers were compared between two groups. Furthermore, visual analogue scale scores were detected. RESULTS AND CONSLUSION:The bone densities of the femoral neck and L1-4 were significantly improved in both groups after treatment (P<0.05). The hormone replacement therapy significantly decreased the serum levels of estradiol and progesterone, and significantly increased the cortisol level (P<0.05). The visual analogue scale scores in the alendronate sodium group were significantly superior to those in the hormone replacement therapy group (P<0.05). Alendronate sodium significantly decreased serum levels of procol agen type I N-terminal peptide and C-terminal cross-linking telopeptide of type I col agen, as wel as significantly increased alkaline phosphatase and osteocalcin compared with the hormone replacement therapy (P<0.05). The incidence of adverse reactions, such as nausea and fatigue, in the hormone replacement therapy group was higher than that in the alendronate sodium group (P<0.05). These results suggest that alendronate sodium and hormone replacement therapies both can markedly improve the bone density and promote osteogenesis;in contrast, alendronate sodium exerts little influence on hormone levels and slight adverse reactions, achieving better treatment outcomes.