Effects of alfacalcidol alone or in combination with elcatonin on incidence of osteoporotic vertebral fractures in postmenopausal women with spondylosis |
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Authors: | Naohisa Miyakoshi Yoichi Shimada Shigeru Ando Takashi Minato Eiji Itoi |
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Institution: | (1) Department of Orthopedic Surgery, Akita University School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan |
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Abstract: | Osteoporosis and spondylosis often occur simultaneously. However, there are no previous reports about the effects of osteoporosis
medication on incidence of vertebral fractures in people with spondylosis. In this study, we conducted a retrospective investigation
of the effects of alfacalcidol alone or in combination with elcatonin on incidence of osteoporotic vertebral fractures in
women with spondylosis. The present subjects were 101 postmenopausal women with osteoporosis aged >60 years, divided into
three groups: D group (n = 45), treated for >5 years with alfacalcidol; D+ECT group (n = 26), treated for >5 years with alfacalcidol plus elcatonin; control group (n = 30), who received no medications for >5 years. Over the 5-year treatment period, bone mineral density (BMD) of the lumbar
spine and proximal femur did not significantly change in the D and D+ECT groups, but they significantly decreased in the control
group (P < 0.05). The number of incident vertebral fractures per patient was significantly higher in the control group (2.9) than
in the D group (1.2) and D+ECT group (1.5) (P < 0.01). There was no significant difference in BMD or incident vertebral fractures between the D and D+ECT groups. In all
three groups, the number of incident vertebral fractures positively correlated with the number of prevalent vertebral fractures
(0.303 ≤ r ≤ 0.434), and negatively correlated with baseline BMD (−0.703 ≤ r ≤ −0.326) and the osteophyte score representing the degree of spondylosis (−0.769 ≤ r ≤ −0.365). Further multiple regression analysis revealed that the medication (D or D+ECT, P < 0.001) and the osteophyte score (P < 0.001) were the most significant contributors for the number of incident vertebral fractures. In conclusion, elcatonin
had no additive effects on BMD or prevention of vertebral fractures in postmenopausal women receiving alfacalcidol. Presence
of spondylosis (indicated by a high osteophyte score) appears to have an effect on prevention of vertebral fractures. |
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Keywords: | osteoporosis spondylosis vertebral fracture alfacalcidol elcatonin |
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