87585
document
Continuous and cyclical clodronate therapies and bone density in postmenopausal bone loss . OBJECTIVE To evaluate the effectiveness of different clodronate regimens in postmenopausal osteoporosis . METHODS In groups of 20 , 60 women were randomly assigned to one of three treatments : oral calcium , 1000 mg/day ; oral calcium plus oral clodronate , 400 mg/day ; oral calcium plus oral clodronate , 400 mg/day for 30 days , followed by a 60-day period of calcium supplement alone . This last regimen was repeated four times in the 12-month study period . RESULTS Patients who received calcium alone showed a decline in spinal bone mass , both after 6 and 12 months ( P < .03 and P < .005 , respectively ) ; femoral density in this group also decreased after 6 and 12 months ( P < .002 and P < .05 , respectively ) . On the other hand , both clodronate-treated groups had increased levels of lumbar bone mass compared with controls , both after 6 and 12 months of therapy . However , at the end of the study , patients treated with cyclical clodronate had higher spinal bone mass compared with those treated continuously ( 3.32 +/- 0.71 versus 0.43 +/- 0.89 % , P < .02 ) . After 6 months , femoral bone density was significantly higher both in subjects treated with clodronate , both cyclically and continuously ( P < .01 ) , compared with controls . Continuous clodronate treatment resulted in a clear fall in biochemical indices of bone resorption , together with a consequent decrease in osteocalcin at 6 ( P < .02 ) and 12 months ( P < .003 ) and a significant increase in parathyroid hormone after 12 months ( P < .001 ) of therapy . CONCLUSION One-year treatment with clodronate induces a gain in bone mass , especially in the spine . The continuous regimen does not result in any further benefit in lumbar bone density over the cyclical one , probably because of a greater suppression of bone turnover .
87586
Intervention_Pharmacological
cyclical clodronate therapies
87587
Intervention_Pharmacological
clodronate
87588
Intervention_Pharmacological
oral calcium , 1000 mg/day ; oral calcium plus oral clodronate , 400 mg/day ; oral calcium plus oral clodronate , 400 mg/day for 30 days , followed by a 60-day period of calcium supplement alone .
87589
Intervention_Pharmacological
calcium alone
87590
Intervention_Pharmacological
clodronate-treated
87591
Intervention_Pharmacological
cyclical clodronate
87592
Intervention_Pharmacological
Continuous clodronate treatment
87593
Intervention_Pharmacological
clodronate
87594
Outcome_Physical
spinal bone mass
87595
Outcome_Physical
spinal bone mass
87596
Outcome_Physical
femoral bone density
87597
Outcome_Physical
bone resorption
87598
Outcome_Physical
parathyroid hormone
87599
Participant_Condition
postmenopausal bone loss
87600
Participant_Condition
postmenopausal osteoporosis
87601
Participant_Sample-size
20
87602
Participant_Sample-size
60
87603
Participant_Sex
women
87604
Participant_Condition
received calcium