Alendronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women

Wells GA, Cranney A, Peterson J, Boucher M, Shea B, Welch V, Coyle D, Tugwell P

Summary

Alendronate for preventing fractures caused by osteoporosis in postmenopausal women

This summary of a Cochrane review presents what we know from research about the effect of alendronate for preventing fractures (broken bones) caused by osteoporosis.

In women who have already been diagnosed with low bone density, putting them at risk for a fracture, or have already had a fracture in the bones of their spine, alendronate:

- may prevent fractures in the spine, hip or wrist, or in bones other than the spine.

In women whose bone density is closer to normal, or who may not yet have had a fracture in the bones of their spine, alendronate:

- probably prevents fractures in the spine

- probably leads to no difference in fractures of the hip, wrist or bones other than the spine.

We often do not have precise information about side effects and complications. This is particularly true for rare but serious side effects. Possible side effects may include digestive problems such as injury to the throat, esophagus and stomach and, less commonly, reduced blood supply to the jaw bone, which causes the bone tissue to break down.

What is osteoporosis and what is alendronate?
Bone is a living, growing part of your body. Throughout your lifetime, new bone cells grow and old bone cells break down to make room for the new, stronger bone. When you have osteoporosis, the old bone breaks down faster than the new bone can replace it. As this happens, the bones lose minerals (such as calcium). This makes bones weaker and more likely to break even after a minor injury, like a little bump or fall. Women are more likely to get osteoporosis after menopause.

Alendronate belongs to the class of drugs called bisphosphonates. It is a type of medication that slows down the cells that break down the old bone.

The best estimate of what happens to women that have already been diagnosed with low bone density or have already had a fracture in the bones of their spine:

Fracture of the spine

              - 12 out of 100 women had a fracture when taking a placebo

              - 6 out of 100 women had a fracture when taking alendronate

Fracture in the hip or wrist

               - 2 out of 100 women had a fracture when taking a placebo

               - 1 out of 100 women had a fracture when taking alendronate

Fractures in bones other than the spine

               - 9 out of 100 women had a fracture when taking a placebo

               - 7 out of 100 women had a fracture when taking alendronate

The best estimate of what happens to women whose bone density is closer to normal or who may not yet have had a fracture in the bones of their spine:

Fracture of the spine

                - 3 out of 100 women had a fracture when taking a placebo

                - 1 out of 100 women had a fracture when taking alendronate

 Fractures in bones other than the spine:

                 - 1 out of 100 women had a hip fracture when taking a placebo

                 - 1 out of 100 women had a hip fracture when taking alendronate

               - 3 out of 100 women had a wrist fracture when taking a placebo

                 - 4 out of 100 women had a wrist fracture when taking alendronate

                - 13 out of 100 women had a fracture somewhere other than the spine when taking a placebo

                 - 12 out of 100 women had a fracture somewhere other than the spine when taking alendronate