Cited by 752Bone health and osteoporosis researchMenopause: Health Impacts and TreatmentsBone health and treatments

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Improvement in spine bone density and reduction in risk of vertebral fractures during treatment with antiresorptive drugs

Cummings, Steven R., Karpf, David B., Harris, Fran, Genant, Harry K., Ensrud, Kristine, LaCroix, Andrea Z., Black, Dennis M.·2002·The American Journal of Medicine

DOI 10.1016/s0002-9343(01)01124-x

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Abstract

Purpose To estimate how much the improvement in bone mass accounts for the reduction in risk of vertebral fracture that has been observed in randomized trials of antiresorptive treatments for osteoporosis.Methods After a systematic search, we conducted a meta-analysis of 12 trials to describe the relation between improvement in spine bone mineral density and reduction in risk of vertebral fracture in postmenopausal women. We also used logistic models to estimate the proportion of the reduction in risk of vertebral fracture observed with alendronate in the Fracture Intervention Trial that was due to improvement in bone mineral density.Results Across the 12 trials, a 1% improvement in spine bone mineral density was associated with a 0.03 decrease (95% confidence interval [CI]: 0.02 to 0.05) in the relative risk (RR) of vertebral fracture. The reductions in risk were greater than predicted from improvement in bone mineral density; for example, the model estimated that treatments predicted to reduce fracture risk by 20% (RR = 0.80), based on improvement in bone mineral density, actually reduce the risk of fracture by about 45% (RR = 0.55). In the Fracture Intervention Trial, improvement in spine bone mineral density explained 16% (95% CI: 11% to 27%) of the reduction in the risk of vertebral fracture with alendronate.Conclusion Improvement in spine bone mineral density during treatment with antiresorptive drugs accounts for a predictable but small part of the observed reduction in the risk of vertebral fracture.

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Self-citation

Authors: Cummings, S. R., Karpf, D. B., Harris, F., Genant, H. K., Ensrud, K., LaCroix, A. Z., & Black, D. M.
Affiliations: University of California, San Francisco (US)
Geron (United States) (US)
University of Minnesota (US)
University of Washington (US)
Corresponding author: Cummings, Steven R.
ORCID: Cummings, Steven R.
Genant, Harry K.
Ensrud, Kristine
LaCroix, Andrea Z.
Black, Dennis M.
Venue: The American Journal of Medicine
Publisher: Elsevier BV
Published: 2002-03
Volume: 112
Issue: 4
Pages: 281-289
ISSN: 0002-9343 (ISSN-L)
DOI: 10.1016/s0002-9343(01)01124-x
OpenAlex: W2110828193
Cited by: 752
References: 35
Citations by year: 2026: 7 · 2025: 10 · 2024: 17 · 2023: 12 · 2022: 12 · 2021: 16 · 2020: 25 · 2019: 10 · 2018: 11 · 2017: 18 · 2016: 25 · 2015: 19 · 2014: 24 · 2013: 29 · 2012: 43
FWCI: 8.42
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: The American Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
eScholarship (California Digital Library) (submittedVersion)
Topics: Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
Health Sciences › Medicine › Oncology › Bone health and treatments
Keywords: osteoporosis, vertebral fractures, bone mineral density, antiresorptive agents, alendronate, postmenopausal women, Fracture Intervention Trial, fracture risk reduction, bone mass
MeSH terms: Bone Resorption, Female, Fractures, Spontaneous, Humans, Regression Analysis, Risk Factors, Spine, Bone Density, Osteoporosis, Postmenopausal, Logistic Models, Spinal Fractures, Alendronate

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Improvement in spine bone density and reduction in risk of vertebral fractures during treatment with antiresorptive drugs

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