A Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Effects of Alendronate on Bone Mineral Density and Bone Remodelling in Perimenopausal Women With Low Bone Mineral Density

Abstract Background Perimenopausal women can experience rapid bone loss at skeletal sites with both cortical and cancellous bone, increasing the prevalence of osteoporosis following menopause. Methods We conducted a 12-month randomized placebo-controlled trial evaluating the effects of alendronate 70 mg with 2800 IU cholecalciferol administered once per week for 12 months in comparison with placebo and cholecalciferol. The primary end-point was the percentage change in the lumbar spine bone mineral density (BMD) from baseline to 12 months. Secondary end-points were the change in BMD at the femoral neck and changes in biochemical markers of bone turnover. Results Forty-five women were recruited to participate in the study. Five subjects withdrew from the study before randomization for unrelated reasons. Forty subjects were randomly allocated to the alendronate and placebo groups. The mean lumbar spine BMD in women treated with alendronate increased by 3.66% (mean paired difference, d ¯ = 0.032 ; ± 0.008 S E ) at 12 months, compared with a reduction of 3.33% d ¯ = − 0.030 ; ± 0.008 S E in the control group ( P < 0.001). In the femoral neck, the mean BMD in the alendronate group increased by 2.07% d ¯ = 0.014 ; ± 0.009 S E at 12 months, compared with a reduction of 1.87% d ¯ = − 0.014 ; ± 0.008 S E in the control group ( P = 0.046). There were no differences in BMD between the alendronate and placebo groups at the total hip sites after 12 months. At 12 months, both bone-specific alkaline phosphatase and urinary N-telopeptide were significantly reduced, by 37.79% d ¯ = − 9.90 ; ± 1.92 S E and 27.21% d ¯ = − 11.68 ; ± 4.80 S E respectively, in the alendronate group; in the control group, these levels increased ( P < 0.001). Conclusion Weekly treatment with alendronate 70 mg and cholecalciferol 2800 IU increases BMD and decreases bone turnover in perimenopausal women.