Department of Obstetrics and Gynecology, Endocrine Research, VCU Medical Center, Richmond, Virginia, USA.
J Womens Health (Larchmt). 2010 Mar;19(3):491-7. doi: 10.1089/jwh.2009.1438.
Although the effects of bisphosphonates in bone are known for postmenopausal women, it is not known if younger postmenopausal women have a similar response. Furthermore, it is not known if the effects of alendronate and risedronate differ in postmenopausal women in regard to age, specifically in women at or younger than the mean age of natural menopause. Our aim was to examine the effects of two oral bisphosphonates in postmenopausal women by age.
This was a post-hoc analysis of postmenopausal women <55 or > or =55 years old with low bone mineral density (BMD), randomized to once weekly alendronate 70 mg or risedronate 35 mg for 1 year with 1-year extensions in U.S. and International Fosamax Actonel Comparison Trials.
In both age subgroups of postmenopausal women, alendronate produced significantly greater mean BMD increases from baseline than risedronate at hip trochanter, lumbar spine, total hip, and femoral neck. Changes in BMD were not significantly different between younger and older alendronate-treated women, although treatment differences favoring alendronate were numerically greater for younger than older postmenopausal women at all sites. Significantly greater reductions in bone turnover markers also occurred with alendronate vs. risedronate in both subgroups. Tolerability was similar between treatments.
In this post-hoc subgroup analysis of older and younger postmenopausal women receiving alendronate or risedronate, larger treatment differences in BMD gain in younger compared with older women suggest that patient age may affect the relative efficacy of these antiresorptive drugs.
尽管人们已经了解了双膦酸盐在绝经后妇女骨骼中的作用，但尚不清楚年轻绝经后妇女是否会有类似的反应。此外，尚不清楚阿伦膦酸盐和利塞膦酸盐在绝经后妇女中的作用是否因年龄而异，特别是在绝经年龄或更年轻的妇女中。我们的目的是通过年龄来研究两种口服双膦酸盐在绝经后妇女中的作用。
这是一项针对年龄<55 岁或≥55 岁、骨密度（BMD）较低的绝经后妇女的事后分析，这些妇女被随机分配接受每周一次的阿伦膦酸盐 70mg 或利塞膦酸盐 35mg 治疗 1 年，并在 1 年的延长期内在美国和国际福善美（Alendronate）阿仑膦酸盐比较试验中接受治疗。
在两个年龄亚组的绝经后妇女中，与利塞膦酸盐相比，阿伦膦酸盐治疗使髋部转子间、腰椎、全髋和股骨颈的平均 BMD 增加更为显著。在接受阿伦膦酸盐治疗的年轻和老年妇女中，BMD 的变化没有显著差异，尽管在所有部位，年轻绝经后妇女接受阿伦膦酸盐治疗的差异都有利于阿伦膦酸盐，但数值上大于老年妇女。在两个亚组中，与利塞膦酸盐相比，阿伦膦酸盐还导致骨转换标志物的显著降低。两种治疗的耐受性相似。
在接受阿伦膦酸盐或利塞膦酸盐治疗的年龄较大和较小的绝经后妇女的这一事后亚组分析中，年轻女性比老年女性的 BMD 增益治疗差异更大，这表明患者年龄可能会影响这些抗吸收药物的相对疗效。
