Oral continuous clodronate in the prevention of early postmenopausal bone loss

Abstract

The aim of this study was to investigate the effects of 12 months of continuous oral clodronate therapy on bone metabolism in healthy early postmenopausal women. A total of 137 evaluable healthy early postmenopausal women were given 400 mg/d oral clodronate continuously for 12 months. Thirty age-matched healthy early postmenopausal women were included as controls. Measures of lumbar L 2–L 4 and ultradistal radius bone mineral density (LBD and URBD, respectively) and bone turnover biochemical analyses were performed at baseline and after 6 and 12 months of therapy. After 12 months, statistically significant increases in LBD (+1.78 ± 0.87%) and in URBD (+4.23 ± 0.91%) were shown in the clodronate group versus the control group (−4.6 ± 0.96% and −2.80 ± 0.51%, respectively; P < 0.01). At the same time, significant decreases in serum osteocalcin (−4.2 ± 1.5%), free calcium (−2.5 ± 0.7%), and urinary hydroxyproline (−9.7 ± 3.8%) levels were observed in the treated group ( P < 0.01 vs baseline). Within the clodronate group, patients were divided into two subgroups on the basis of biochemical indexes indicating a normal (subgroup N) or high (subgroup H) bone turnover. Statistically significant differences between subgroups N and H were observed after 6 and 12 months in the percent change in ultradistal forearm mineral density, serum alkaline phosphatase, and urinary hydroxyproline excretion. Thus 12 months of oral clodronate treatment was shown to be effective in preventing bone loss in early postmenopausal women, and the drug was particularly effective in high bone turnover conditions.