Effect of Alendronate and Teriparatide on Bone Mineral Density in Postmenopausal Women

Abstract

Background: Alendronate and teriparatide have been proved to benefit osteoporosis patients in some prospective studies. However, no data have been described about the clinical practice of these medications and their efficacy in Taiwanese people.Method: We reviewed the medical records of an outpatient clinic at National Taiwan University Hospital from 2008 to 2010, and collected data on the postmenopausal women diagnosed with osteoporosis or spinal compression fracture. Lumbar spinal bone mineral density (BMD) was recorded at baseline and at 6, 12, 18, 30, and 42 months after initiating therapy. We compared the patients' BMD before and after the treatment by paired t test. Mixed model for repeated BMD measurement was used to determine the effect of age, baseline BMD, and different medications on BMD.Results: Thirty-seven patients received alendronate and 25 received teriparatide. Mean T scores of BMD before treatment were -3.18 ± 0.57 and -3.30 ± 0.74 in the alendronate and teriparatide groups, respectively. After treatment, BMD increased significantly (alendronate group, p = 0.003; teriparatide group, p＜0.001). The effects on BMD were comparable between the alendronate and teriparatide groups (p=0.74). Patients with higher baseline BMD responded to the medications significantly better than patients with lower baseline BMD. Adverse events were mild and few for both medications.Conclusions: Alendronate and teriparatide could increase lumbar spinal BMD in postmenopausal Taiwanese, with comparable efficacy between the two drugs. Patients with higher baseline BMD responded better to the medications.