口服国产阿伦膦酸钠治疗绝经后骨质疏松症的疗效评价

目的为评价国产阿伦膦酸钠（ＡＬＮ）治疗绝经后骨质疏松症（ＰＭＯ）的有效性和安全性。方法将确诊的１８９例ＰＭＯ患者的前１２０例随机地分为试验组与对照组，其余６９例作为开放组。试验组与开放组口服ＡＬＮ１０ｍｇ／日，对照组服安慰剂。三组均日服等量的磷酸氢钙（含元素钙５１０ｍｇ），疗程为１年。结果试验组与开放组腰椎骨密度分别增加了６．３％及６．０％，明显高于对照组１．７％，且两组椎体无新发压缩性骨折发生，而对照组新发６例。骨痛缓解率也明显高于对照组。骨吸收与骨形成指标（尿Ｈｙｐ／Ｃｒ、ＡＬＰ、骨特异性ＡＬＰ、骨钙素），于治疗第３、６及１２月下降幅度亦明显大于对照组（Ｐ＜０．０５～０．００１）。部分病例有轻度、一过性胃肠道反应，但不影响治疗。三组血、尿常规及肝、肾功能未见异常改变。结论国产ＡＬＮ１０ｍｇ／日治疗ＰＭＯ有效、安全。     

鲑鱼降钙素联合钙剂与单用钙剂治疗老年原发骨质疏松症临床观察

目的 观察鲑鱼降钙素联合钙剂与单用钙剂治疗原发老年性骨质疏松症的疗效.方法 100例原发骨质疏松引起疼痛老年病人随机分成两组,(1)鲑鱼降钙素联合钙剂观察组(50例);(2)单用钙剂治疗对照组(50例).结果 治疗6个月后,观察组骨痛症状明显改善,患者评价优良率达86%,同时腰椎L2-4股骨颈部的骨密度较治疗前增加(P＜0.01);对照组腰椎L2-4股骨颈部的骨密度较用药前无明显改变(P＞0.05).结论 鲑鱼降钙素与钙剂联合治疗老年性骨质疏松症,能有效缓解骨痛,提高患者的骨量.     

鲑鱼降钙素治疗糖尿病合并骨质疏松症的疗效观察

52例糖尿病合并骨质疏松症患者随机分成两组,均用药5个月。鲑鱼降钙素治疗组（26例）,单用钙剂口服治疗组（26例）。结果：治疗5个月后,治疗组骨痛症状明显改善,疼痛缓解率达89．76％,骨密度显著增加（P〈0．05）。结论：鲑鱼降钙素治疗糖尿病合并骨质疏松症,能有效缓解骨痛,提高患者骨密度,效果良好。     

鲑鱼降钙素治疗骨质疏松症的临床观察

目的探讨鲑鱼降钙素治疗绝经后骨质疏松症的疗效。方法应用鲑鱼降钙素治疗９例绝经后骨质疏松症患者２０周，观察治疗前后腰椎骨密度及生化指标的变化。结果腰椎２～４骨密度在治疗前分别为０．５５±０．１４、０．５６±０．１６、０．６４±０．０７ｇ／ｃｍ２，治疗后分别为０．６２±０．０８、０．６５±０．１３、０．６６±０．０９ｇ／ｃｍ２，差异均有显著性（Ｐ＜０．０１）；血清降钙素水平明显升高，差异亦有显著性（Ｐ＜０．０１），甲状旁腺激素水平无明显变化（Ｐ＞０．０５），骨钙素水平在治疗后均正常。结论鲑鱼降钙素治疗绝经后骨质疏松症有较好效果。     

鲑鱼降钙素治疗糖尿病合并骨质疏松的临床研究

目的探讨鲑鱼降钙素治疗糖尿病合并骨质疏松的临床疗效。方法选择2013年5月—2014年10月齐齐哈尔市富拉尔基区北兴社区卫生服务中心随访的糖尿病合并骨质疏松患者120例。按自愿的原则分为治疗组和对照组,治疗组采用鲑鱼降钙素(该研究使用诺华制药有限公司生产的密钙息)50 IU隔日1次皮下注射和钙尔奇D(含无素钙600 mg、维生素D3125IU)1片/d口服联合治疗。对照组单纯使用钙尔奇D 1片/d口服。连续治疗24周后测量骨密度(BMD)、血钙、碱性磷酸酶及疼痛进行评价。结果治疗组治疗前后的对比,骨密度明显增加,疼痛明显轻,血钙明显升高,碱性磷酸酶监测值明显下降,总体效率优于对照组。结论鲑鱼降钙素联合钙尔奇D治疗糖尿病合并骨质疏松能明显抑制骨吸收,增加骨质含量,值得临床推广。     

降钙素治疗老年骨质疏松症的临床研究

目的　观察鲑鱼降钙素对老年骨质疏松症的治疗效果。　方法　将经双能X线骨密度仪 (DEXA)测定确诊为骨质疏松且有临床症状的老年患者 86例分成两组 ,鲑鱼降钙素组 4 6例 ,予以鲑鱼降钙素肌肉注射 ,每天 1次 10 0IU ,连用 3d后 ,改为 5 0IU隔天 1次 ,连用 1个月 ,间歇 1个月后再重复 ,共半年 ,同时加服钙尔奇D每天 1片 ;对照组 4 0例 ,单纯口服钙尔奇D每天 1片 ,疗程半年 ,两组治疗前后均测定 1～ 4腰椎 (L1-4)及股骨近端骨密度 (BMD) ,治疗后记录临床症状。　结果　鲑鱼降钙素组较对照组骨痛症状缓解 (91 3%和 4 7 5 % )效果明显 (P <0 0 1) ,鲑鱼降钙素组腰椎BMD (0 78± 0 12 ) g/cm2 较治疗前 (0 73± 0 10 ) g/cm2 有所升高 (P <0 0 5 ) ,股骨近端BMD变化不明显 ;对照组BMD无明显改变。　结论　鲑鱼降钙素与钙剂联合对治疗老年骨质疏松患者有缓解临床症状及增加腰椎BMD的作用。     

阿伦膦酸钠防治原发性骨质疏松症

目的观察阿伦膦酸钠（福善美Ｆｏｓａｍａｘ）对原发性骨质疏松症妇女治疗的有效性和安全性。方法本研究为多中心开放研究，８１例原发性骨质疏松症妇女接受每日口服福善美１０ｍｇ和元素钙５００ｍｇ（碳酸钙）。平均年龄６５±６岁，绝经年限１５±６年，完成３月、６月和１２月治疗者分别有７９、７６和７０例。观察用药后骨密度的改变及不良反应。结果腰椎２４（Ｌ２４）骨密度于治疗３月、６月和１２月时均较疗前有非常明显的升高（Ｐ＜０．００１），升高率分别为２．８％、４．１％和６．３％。服药６月较３月、１２月较６月均见进一步增高（Ｐ＜０．０１）。髋部三个部位的骨密度在３月、６月和１２月都较疗前有显著升高，其中以大转子最显著（Ｐ＜０．００１），升高２．６％～２．９％，其次为股骨颈和Ｗａｒｄｓ三角，均较疗前有增高，但在１２月治疗期间未见逐步进行性增高。与试验药物很可能有关的不良反应有４例，主要为上消化道症状。未发生与药物有关的严重不良反应。结论福善美对中国妇女骨质疏松症治疗一年表明其是有效和安全的。     

鲑鱼降钙素治疗老年骨质疏松患者的疗效观察

目的 探讨鲑鱼降钙素注射液治疗老年骨质疏松(0P)患者的疗效.方法 将120例OP患者随机分成实验组和对照组,每组各60人,实验组用鲑鱼降钙素联合钙剂治疗,对照组单纯使用钙剂治疗.两组治疗前后均测定24腰椎、骨股颈及wards三角骨密度,记录患者临床症状.结果 治疗2个月后,实验组骨痛改善率明显高于对照组(P＜0.05),治疗6个月后实验组血清钙均值及尿羟脯氨酸(HOP)均值均有明显变化(P＜0.05),实验组患者L2-L3、腰椎均值骨密度(BMD)较前明显升高(P＜0.05).对照组BMD治疗前后无明显变化(P＞0.05).结论 鲑鱼降钙素与钙剂联合应用治疗老年OP,能明显减轻患者疼痛,改善症状,增加BMD,是一种疗效良好的安全方法.     

鲑鱼降钙素对骨质疏松患者骨密度的影响

目的 观察肌注鲑鱼降钙素对骨质疏松患者骨密度的治疗效果。方法 双能X线骨密度测定确诊的骨质疏松患者,自愿分组。降钙素(sCT)组共50例,予鲑鱼降钙素肌肉注射,每次50IU,隔日1次;同时每日口服1片钙尔奇-D。钙(Ca)组共65例,每日予相等剂量钙尔奇-D治疗。两组均治疗24周。治疗前后测定腰椎L2～4侧位、股骨近端骨密度(BMD)及血清骨钙蛋白(BGP)、碱性磷酸酶(ALP)等指标。结果 sCT组治疗后腰椎各椎体BMD增加3.47％～3.74％,股骨近端各部位BMD增加1.44％～1.72％;Ca组则分别下降1.29％～1.83％和1.98％～2.11％(P<0.02)。结论 鲑鱼降钙素可有效增加腰椎、股骨近端骨密度或减少骨质丢失,其中对腰椎的治疗效果较股骨近端佳。     

鲑鱼降钙素治疗老年男性骨质疏松症临床观察

目的 观察鲑鱼降钙素对老年男性骨质疏松症患者的疗效.方法 将60例老年男性骨质疏松症患者分为治疗组和对照组各30例.对照组服用维D钙咀嚼片+骨化三醇软胶囊;治疗组在此基础上应用鲑鱼降钙素鼻喷剂,疗程均为6个月.检测治疗前及治疗后骨密度、生化指标和骨代谢标志物;计算总有效率,观察不良反应发生情况.结果 治疗组治疗前后骨密度分别为(0.307±0.083)、(0.355±0.098) g/cm2,对照组分别为(0.298±0.096)、(0.303±0.092) g/cm2;治疗组治疗后骨密度高于治疗前及同期对照组,血清1,25双羟基维生素D3[1,25(OH)2D3]、骨特异性碱性磷酸酶(BALP)水平高于治疗前及同期对照组,血清抗酒石酸酸性磷酸酶5b(TRACP5b)水平低于治疗前及同期对照组(P均＜0.05).治疗组、对照组骨痛缓解总有效率分别为93.33％、36.67％,治疗组总有效率高于对照组(P＜0.01).结论 鲑鱼降钙素可明显改善老年男性骨质疏松症患者的骨密度,有效缓解骨痛,促进骨形成,抑制骨吸收.     

降钙素治疗老年性骨质疏松症45例临床观察

目的　 观察降钙素对老年性骨质疏松症 (OP)的作用。　 方法 　将 80例OP病人随机分成 2组 ,降钙素组 45例 ,隔日肌注降钙素 5 0U ,每日加服碳酸钙 维生素D 0 6 ,对照组 35例 ,每日碳酸钙 维生素D 0 6 ,疗程均为 6月 ,每组用药 6月前后分别检测腰椎前后位、腰椎 3侧位右髋部骨密度 (BMD)、血清碱性磷酸酶 (ALP)、骨钙素(BGP)、酸性磷酸酶 (ACP)及尿吡啶酚 /肌酐 (Pyd/Cr)比值。　 结果 　降钙素组腰椎前后位 1～ 4及腰 3侧位BMD分别升高 11 8%、9 3 %、8 2 %、10 2 %和 10 3 % ,髋部BMD升高不明显 ,与此同时 ,血清ALP、BGP、ACP及Pyd/Cr比值明显降低 (P <0 0 5 ) ,疼痛改善。对照组用药物后无明显改变。　 结论 　小剂量降钙素能够增加老年性OP病人腰椎BMD ,其机理与抑制骨吸收 ,降低骨转换率有关。     

鲑鱼降钙素鼻喷剂治疗绝经后骨质疏松患者骨密度及骨转换指标的变化

目的 观察鼻喷鲑鱼降钙素(calcitonin)治疗绝经后骨质疏松症(postmenopausal osteoporosis,PMO)患者6个月和12个月后骨密度及骨转换指标的变化.方法 选择PMO患者共67例,给予鼻喷降钙素治疗37例;其余30例PMO患者单纯服用钙剂和维生素D作为对照组.各组分别于用药前和用药后6个月和12个月采用DEXA骨密度仪测定骨密度;定量夹心酶联免疫法(ELISA)测定Ⅰ型胶原N末端肽(NTX)、骨特异性碱性磷酸酶(BALP)、抗酒石酸酸性磷酸酶(TRACP-5b)、25-羟维生素D,化学发光法测定骨钙素(BGP).结果 5例患者因医疗费用、拒绝坚持治疗退出试验,鼻喷降钙素组共32例完成试验.鼻喷降钙素治疗6个月后可见患者股骨颈和腰椎骨密度均较前有所增加,但仅在腰椎差异有统计学意义(P＜0.05),而在股骨颈治疗前后骨密度的差异无统计学意义(P＞0.05).治疗12个月时股骨颈和腰椎骨密度较前均明显升高,差异有统计学意义(P＜0.05).对照组在治疗6个月时的腰椎和治疗12个月时的股骨颈和腰椎部位骨密度均较治疗前降低,差异有统计学意义(P＜0.05).鼻喷降钙素治疗6个月和12个月时,股骨颈和腰椎骨密度均较对照组升高(P＜0.05).鼻喷降钙素治疗6个月后,TRACP-5b、NTX/Cr较治疗前降低,差异有统计学意义(P＜0.05);治疗12个月后,除TRACP-5b、NTX/Cr较前降低更加明显以外(P＜0.01),BALP较治疗前有升高,差异有统计学意义(P＜0.05).对照组在治疗12个月时,BALP较前有降低,差异有统计学意义(P＜0.05).25-羟维生素D在各组经治疗后,均明显升高,差异有统计学意义.结论 本研究结果显示鼻喷降钙素治疗6个月有效,12个月效果显著,可预防骨丢失,增加骨量.

Abstract：

Objective To study the changes of bone mineral density(BMD)and bone turnover in postmenopausal osteoporotic patients treated with salmon calcitonin nasal spray. Methods Sixty-seven postmenopausal osteoporotic patients were enrolled in our trial. All of them received calcium and vitamin D; 37patients were treated with salmon calcitonin nasal spray for 12 months and the other 30 patients received calcium and vitamin D only. Dual-energy X-ray absorptiometry(DEXA)and measurements of a series of bone turnover indices were performed before and after medication for 6 and 12 months. Results After treatment with salmon calcitonin nasal spray for6 months, BMD in lumbar spine 2-4 increased but no change occurred in femoral neck. However, after treatment for 12 months, BMD in both lumbar spine 2-4 and femoral neck increased. In the control group, BMD in lumbar spine 2-4 decreased after treatment for 6 and 12 months, but BMD in femoral neck decreased only after 12months. Comparing with the control group, after treatment with salmon calcitonin nasal spray, BMD in lumbar spine 2-4 and femoral neck were increased obviously. The level of TRACP-5b and NTX/Cr decreased after treatment with salmon calcitonin nasal spray for6 months and 12 months, while BALP increased only after treatment for 12 months. In the control group, BALP decreased after treatment for 12 months. The level of 25-(OH)vitamin D increased after treatment for 6 months and 12 months in both groups. Conclusions Long-term treatment with salmon calcitonin nasal spray prevents bone loss and may increase bone mass.     

中波紫外线照射治疗绝经后骨质疏松的临床研究

目的 探讨中波紫外线照射仪对绝经后骨质疏松的治疗作用.方法 选择符合诊断标准的绝经后骨质疏松患者99例随机分为A、B、C三组,在A组35例肾阳虚型绝经后骨质疏松患者用中波紫外线照射治疗;B组34例肾阴虚型绝经后骨质疏松患者用中波紫外线照射治疗,两组均加服钙剂(2 g/ d).对照组C组,30例绝经后骨质疏松患者肌注鲑鱼降钙素,同时加服钙剂 (2 g/ d).观察治疗前后血清1,25(OH)2D3、Young Z、腰椎骨密度(BMD)的变化.结果 中波紫外线照射治疗肾阳虚组血清1,25(OH)2D3、Young Z、腰椎BMD在治疗前后差异均有显著性,与肾阴虚组比较有显著差异.C组各观察指标无明显变化.结论 中波紫外线照射对绝经后肾阳虚型骨质疏松有较好的疗效,可提高骨密度,改善骨代谢.     

Salmon calcitonin nasal spray : An effective alternative to estrogen therapy in select postmenopausal women

The efficacy and safety of estrogen replacement therapy (ERT) and salmon calcitonin in the treatment of postmenopausal osteoporosis are reviewed with special consideration given to patients for whom ERT, the primary antiresorptive therapy for osteoporosis, is not indicated, tolerable, or is refused. The various formulations of estrogen and salmon calcitonin, for which the nasal spray formulation was recently approved for use in the United States, are reviewed in depth with reference to dose ranges, side effects, and convenience. Data regarding increases in bone mineral density (BMD) produced by each agent are presented. Specifically, the range of increases in BMD induced by ERT and salmon calcitonin are comparable. Given the substantial public health consequences of postmenopausal osteoporosis and osteoporotic fractures, the primary care physician is increasingly faced with the need to educated and recruit postmenopausal patients to appropriate therapy with the optimal agent for that particular patient. In the many patients who are unable or unwilling to accept, initiate, and comply with prescribed ERT, alternative therapeutic options are necessary Based on the established safety profile of salmon calcitonin, ease of administration, an uncomplicated dosing regimen, no reported drug interactions, and the lack of uterine bleeding associated with ERT or gastrointestinal adverse effects of other agents used to treat osteoporosis, salmon calcitonin nasal spray is an appropriate alternative approach for the treatment of postmenopausal bone loss.     

Effects of alendronate on metacarpal and lumbar bone mineral density,bone resorption,and chronic back pain in postmenopausal women with osteoporosis

The purpose of this study was to investigate the effect of alendronate on metacarpal and lumbar bone mineral density (BMD), bone resorption, and chronic back pain in postmenopausal women with osteoporosis. Eighty postmenopausal women with osteoporosis, 59–88 years of age, were divided into two groups of 40 each according to the site of BMD measurement: the metacarpus (M) and the lumbar spine (L). All of them were treated with alendronate (5 mg/day) for 12 months. Metacarpal or lumbar BMD was measured by computed X-ray densitometry or dual-energy X-ray absorptiometry in the M or the L group, respectively, at baseline and every 6 months. Urinary cross-linked N-terminal telopeptides of type I collagen (NTX) were measured by enzyme-linked immunosorbent assay, and chronic back pain was evaluated by face scale score at baseline and every 6 months in both groups. There were no significant differences in baseline characteristics, including age, body mass index, years since menopause, urinary NTX level, face scale score, or number of prevalent vertebral fractures per patient between the two groups. Urinary NTX level was reduced and chronic back pain was improved similarly in both groups. Whereas metacarpal BMD did not significantly change in the M group (0.20% increase), lumbar BMD increased by 8.15% in the L group. These results suggest that although alendronate increases BMD of the lumbar spine, which is rich in cancellous bone, and improves chronic back pain, with suppression of bone resorption in postmenopausal women with osteoporosis, it may fail to increase cortical BMD of the metacarpus, a distal site of the upper extremity.Abbreviations ALP Alkaline phosphatase - BMD Bone mineral density - DXA Dual-energy X-ray absorptiometry - NTX Cross-linked N-terminal telopeptides of type I collagen     

Effect of salmon calcitonin on bone mineral density and calcium-phosphate metabolism in chronic hemodialysis patients with secondary hyperparathyroidism

The aim of the study was to evaluate the effect of salmon calcitonin on bone mineral density, parathyroid and thyroid C cells, and calcium-phosphate metabolism in chronic hemodialysis patients with uremic hyperparathyroidism. Forty five patients with serum 1-84 PTH >220 pg/ml were divided into 2 groups: group I (n = 25), treated with intranasal salmon calcitonin (200 IU, thrice a week) and control group II (n = 20). Patients received calcium carbonate (up to 6 g/d) alone or with aluminum hydroxide (up to 3 g/d) as phosphate binders; dialysate calcium was 1.75-2 mmol/l. The observation period was 12 months. The following parameters were measured: bone mineral density (BMD) with dual-energy X-ray absorptiometry in: lumbar spine (L2-L4), femoral neck and total body, before and after the study; serum endogenous calcitonin, before and after the study; serum PTH, alkaline phosphatase and total hydroxyproline, before and after 1, 3, 6, and 12 months; and serum calcium and phosphate monthly. During 12 months of the study, a substantial reduction in BMD was observed in all examined regions in group II (-2.8 +/- 2.1%; p<0.01 in L2-L4, -2.4 +/- 2.0%; p<0.01 in femoral neck, and -1.9 +/- 1.4%; p<0.01 in total body), whereas in group I a slight increase of bone mineral was noted, however insignificant. The inhibition of bone resorption was accompanied by a marked decrease in serum hydroxyproline. No changes in parathyroid activity were noted nor any decrease in serum phosphate. The treatment had no influence on serum endogenous calcitonin; initial concentrations were elevated in 47% of patients. CONCLUSION: Intranasal salmon calcitonin: 1) has no influence on bone mineralization in dialysis patients with uremic hyperparathyroidism; 2) has no significant effect on serum phosphate concentration; 3) provided adequate calcium supplementation doesn't stimulate parathyroid glands; 4) has no influence on endogenous calcitonin secretion.     

Calcitonin versus Clodronate in the Prevention of Ovariectomy-Induced Osteopenia in Rats

The effects of salmon calcitonin and clodronate were compared in ovariectomised rats. Sixty female Wistar rats (∼260 g in weight) were fed the same diet and had the same living conditions. The rats were divided into the following groups: 15 rats with sham ovariectomy and no drug treatment (Sham-OVX); 45 rats with bilateral ovariectomy subdivided into 15 rats not receiving drug treatment (OVX group), 15 rats treated with subcutaneous salmon calcitonin, 2 U/kg/day every 2 days (OVX + CT group) and 15 rats treated with subcutaneous clodronate, 5 mg/kg/day every 2 days (OVX + Cl group). Sixty days after surgery, the rats were sacrificed and their femurs and fifth lumbar vertebrae were dissected and cleaned of soft tissue. Femur length, vertebral height, and bone mineral content and bone mineral density of the femur and fifth lumbar vertebra by dual-energy X-ray absorptiometry were measured. Calcitonin had a significant and stronger effect in preventing ovariectomy-induced osteopenia in the femur (OVX + CT vs OVX groups, p<0.0001); both calcitonin and clodronate had a significant effect on the fifth lumbar vertebra, which was greater in the calcitonin group (OVX + CT vs OVX + Cl groups, p<0.005). These findings indicate that calcitonin has a protective effect on both the axial (trabecular bone) and peripheral (cortical bone) skeletons, but clodronate only has a protective effect on the axial skeleton. Received: 28 May 1999 / Accepted: 29 July 1999     

Comparison of alendronate and intranasal calcitonin for treatment of osteoporosis in postmenopausal women

This study compared the effects of oral alendronate and intranasal calcitonin for treatment of osteoporosis in postmenopausal women. Women at least 5 yr postmenopause (n = 299) were randomized to either 10 mg alendronate, matching alendronate placebo, or open-label intranasal calcitonin 200 IU daily for 12 months. Hip and spine bone mineral density (BMD) and markers of bone turnover were measured, and safety and tolerability were assessed. Alendronate produced greater increases in BMD than calcitonin at 12 months at the lumbar spine (5.16% vs. 1.18%; P < 0.001), trochanter (4.73% vs. 0.47%; P < 0.001), and femoral neck (2.78% vs. 0.58%; P < 0.001). Changes in BMD with calcitonin were greater than with placebo at the femoral neck, but were not different from placebo at either the trochanter or lumbar spine. Greater decreases in bone turnover were seen with alendronate than with calcitonin (serum bone-specific alkaline phosphatase, 43% vs. 9%, P < 0.001; urinary N-telopeptide, 62% vs. 11%, P < 0.001). Similar percentages of patients in each group reported an adverse experience during the study. We conclude that, in postmenopausal women with osteoporosis, 12 months of therapy with alendronate produced significantly greater increases in BMD of the hip and spine and greater decreases in bone turnover than intranasal calcitonin.     

Comparative efficacy of hormone replacement therapy, etidronate, calcitonin, alfacalcidol, and vitamin K in postmenopausal women with osteoporosis: The Yamaguchi Osteoporosis Prevention Study

PURPOSE: To assess the comparative effectiveness of several medications on bone mineral density, biochemical bone markers, and the incidence of vertebral fractures in postmenopausal women with osteoporosis. METHODS: A total of 396 postmenopausal women, aged 50 to 75 years, were allocated randomly to six equal-sized groups: hormone replacement therapy, etidronate, eel calcitonin, alfacalcidol, vitamin K (menatetrenone), or control (no treatment). Thoracic and lumbar spine radiographs, bone mineral density at the distal radius, and markers of bone turnover were assessed at baseline and every 3 months during the 2-year study. RESULTS: Compared with baseline, the 2-year mean changes in bone mineral density were 2.0% for hormone replacement therapy, -0.5% for etidronate, 1.6% for calcitonin, -3.6% for alfacalcidol, -1.9% for vitamin K, and -3.3% for control. Seventeen (26%) of the 66 control patients developed new vertebral fractures. Compared with controls, the relative risks of vertebral fracture were 0.35 (95% confidence interval [CI]: 0.14 to 0.83) for hormone replacement therapy, 0.40 (95% CI: 0.17 to 0.92) for etidronate, 0.41 (95% CI: 0.17 to 0.93) for calcitonin, 0.56 (95% CI: 0.26 to 1.12) for alfacalcidol, and 0.44 (95% CI: 0.20 to 0.99) for vitamin K. CONCLUSION: We observed significant reductions in the incidence of vertebral fractures with hormone replacement therapy, etidronate, and calcitonin, and significant improvements in bone mineral density with hormone replacement therapy and calcitonin.