Abstract
BackgroundOsteoporosis is a serious disease that causes bone fragility fractures and increases mortality. Bisphosphonates are the first-line drugs for osteoporosis. However, the gains in bone mineral density by use of bisphosphonates alone are limited.Case presentationWe describe the clinical outcome of a Japanese woman with osteoporosis treated with bisphosphonates after multiple spinal fractures. After 3 years of treatment with the bisphosphonate alendronate, her lumbar bone mineral density and bilateral hip bone mineral density markedly increased by 61.9% and 32.5%, respectively.ConclusionWe considered that our patient’s multiple fractures had caused a decrease in bone mineral density, which naturally improved with fracture healing to enhance the increase in bone mineral density with bisphosphonate treatment.
Highlights
Osteoporosis (OP) is a serious and widespread disease that predisposes patients to bone fragility fractures and increases mortality
Bone et al observed that alendronate (ALN) provided increases of 13.8% in lumbar spine bone mineral density (BMD) (L-BMD) and 7.8% in total hip BMD (H-BMD) during 10 years [4]
At 3 years of ALN monotherapy, L-BMD and H-BMD were markedly increased by 61.9% and 32.5%, respectively (Figs. 1, 2), which remained high over a treatment period of 6.5 years
Summary
Osteoporosis (OP) is a serious and widespread disease that predisposes patients to bone fragility fractures and increases mortality. Bisphosphonates (BPs) are the first-line drugs for OP treatment to increase bone mineral density (BMD) and prevent fractures [1, 2]. Case presentation Our patient was a 59-year-old Japanese woman 49 kg in weight and 153.2 cm in height Her chief complaint upon presentation was severe back pain. Bone scintigraphy revealed high accumulation at one lumbar vertebra and one thoracic vertebra, with diffuse mild uptake throughout the entire spine She was diagnosed with OP in accordance with the revised criteria established by the Japanese Society for Bone and Mineral Research [6]. During 2 years of treatment, the patient’s urinary N-terminal telopeptide of type I collagen (NTX) decreased by 95.6% and serum bone alkaline phosphatase (BAP) fell by 85.6%. The patient gave written informed consent for publication of her personal medical information prior to the start of treatment
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