Cortical bone loss at the tibia in postmenopausal women with osteoporosis is associated with incident non-vertebral fractures: Results of a randomized controlled ancillary study of HORIZON

Popp, Albrecht W.; Buffat, Helena; Cavelti, Ariane; Windolf, M.; Perrelet, R.; Senn, Christoph; Lippuner, Kurt (2014). Cortical bone loss at the tibia in postmenopausal women with osteoporosis is associated with incident non-vertebral fractures: Results of a randomized controlled ancillary study of HORIZON. Maturitas, 77(3), pp. 287-293. Elsevier 10.1016/j.maturitas.2013.12.013

[img] Text
PMID 24485216.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (963kB) | Request a copy

BACKGROUND In postmenopausal women, yearly intravenous zoledronate (ZOL) compared to placebo (PLB) significantly increased bone mineral density (BMD) at lumbar spine (LS), femoral neck (FN), and total hip (TH) and decreased fracture risk. The effects of ZOL on BMD at the tibial epiphysis (T-EPI) and diaphysis (T-DIA) are unknown. METHODS A randomized controlled ancillary study of the HORIZON trial was conducted at the Department of Osteoporosis of the University Hospital of Berne, Switzerland. Women with ≥1 follow-up DXA measurement who had received ≥1 dose of either ZOL (n=55) or PLB (n=55) were included. BMD was measured at LS, FN, TH, T-EPI, and T-DIA at baseline, 6, 12, 24, and 36 months. Morphometric vertebral fractures were assessed. Incident clinical fractures were recorded as adverse events. RESULTS Baseline characteristics were comparable with those in HORIZON and between groups. After 36 months, BMD was significantly higher in women treated with ZOL vs. PLB at LS, FN, TH, and T-EPI (+7.6%, +3.7%, +5.6%, and +5.5%, respectively, p<0.01 for all) but not T-DIA (+1.1%). The number of patients with ≥1 incident non-vertebral or morphometric fracture did not differ between groups (9 ZOL/11 PLB). Mean changes in BMD did not differ between groups with and without incident fracture, except that women with an incident non-vertebral fracture had significantly higher bone loss at predominantly cortical T-DIA (p=0.005). CONCLUSION ZOL was significantly superior to PLB at T-EPI but not at T-DIA. Women with an incident non-vertebral fracture experienced bone loss at T-DIA.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Osteoporosis

UniBE Contributor:

Popp, Albrecht; Cavelti, Ariane; Senn, Christoph and Lippuner, Kurt

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0378-5122

Publisher:

Elsevier

Language:

English

Submitter:

Romain Perrelet

Date Deposited:

05 May 2014 14:53

Last Modified:

05 Nov 2015 09:14

Publisher DOI:

10.1016/j.maturitas.2013.12.013

PubMed ID:

24485216

Uncontrolled Keywords:

Fracture risk, Post-dose symptoms, Postmenopausal osteoporosis, Tibial BMD, Zoledronate

BORIS DOI:

10.7892/boris.49773

URI:

https://boris.unibe.ch/id/eprint/49773

Actions (login required)

Edit item Edit item
Provide Feedback