Fracture Risk Reduction with Alendronate in Women with Osteoporosis: The Fracture Intervention Trial
Abstract
We examined the effect of alendronate treatment for 3-4 yr on risk of new fracture among 3658 women with osteoporosis enrolled in the Fracture Intervention Trial. This cohort included women with existing vertebral fracture and those with osteoporosis as defined by T score of less than -2.5 at the femoral neck but without vertebral fracture. All analyses were prespecified in the data analysis plan. The magnitudes of reduction of fracture incidence with alendronate were similar in both groups. The two groups were, therefore, pooled to obtain a more precise estimate of the effect of alendronate on relative risk of fracture (relative risk, 95% confidence interval): hip (0.47, 0.26-0.79), radiographic vertebral (0.52, 0.42-0.66), clinical vertebral (0.55, 0.36-0.82), and all clinical fractures (0.70, 0.59-0.82). Reductions in risk of clinical fracture were statistically significant by 12 months into the trial. We conclude that reductions in fracture risk during treatment with alendronate are consistent in women with existing vertebral fractures and those without such fractures but with bone mineral density in the osteoporotic range. Furthermore, reduction in risk is evident early in the course of treatment. This pooled analysis provides a more precise estimate of the antifracture efficacy of alendronate in women with osteoporosis than that in prior reports.
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There is abundant evidence that the elevated risk of fracture in patients with osteoporosis by BMD is reduced with pharmacotherapy.
“There is abundant evidence that the elevated risk of fracture in patients with osteoporosis by BMD is reduced with pharmacotherapy [52, 57, 59–70].”
From Clinician’s Guide to Prevention and Treatment of Osteoporosis (2014) · cites this paper as [59]
Alendronate reduces the incidence of spine and hip fractures by about 50% over 3 years in patients with a prior vertebral fracture or in patients who have osteoporosis at the hip site.
“Alendronate reduces the incidence of spine and hip fractures by about 50 % over 3 years in patients with a prior vertebral fracture or in patients who have osteoporosis at the hip site [49, 59].”
From Clinician’s Guide to Prevention and Treatment of Osteoporosis (2014) · cites this paper as [59]
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- Authors
- Black, D. M., Thompson, D. E., Bauer, D. C., Ensrud, K., Musliner, T., Hochberg, M. C., Nevitt, M. C., Suryawanshi, S., & Cummings, S. R.
- Affiliations
- University of California, San Francisco (US)
- Merck & Co., Inc., Rahway, NJ, USA (United States) (US)
- University of Maryland, Baltimore (US)
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2000-11
- Volume
- 85
- Issue
- 11
- Pages
- 4118-4124
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2005298224
- Cited by
- 982
- References
- 24
- Citations by year
- 2026: 6 · 2025: 17 · 2024: 19 · 2023: 23 · 2022: 23 · 2021: 37 · 2020: 30 · 2019: 21 · 2018: 33 · 2017: 22 · 2016: 35 · 2015: 30 · 2014: 36 · 2013: 44 · 2012: 45
- FWCI
- 30.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- 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
- alendronate, osteoporosis, fracture risk reduction, Fracture Intervention Trial, vertebral fractures, hip fracture, bone mineral density, women, bisphosphonates, antifracture efficacy
- MeSH terms
- Aged, Female, Follow-Up Studies, Humans, Radiography, Risk Factors, Time Factors, Cohort Studies, Osteoporosis, Postmenopausal, Incidence, Spinal Fractures, Treatment Outcome, Alendronate, Fractures, Bone
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