Alendronate versus Calcitriol for the Prevention of Bone Loss after Cardiac Transplantation

This randomized trial compared alendronate with calcitriol for the prevention of bone loss during the first year after cardiac transplantation. A reference group concurrently underwent transplantation but did not receive either drug. Bone loss and the rate of fractures did not differ significantly between the intervention groups. Both intervention groups sustained less bone loss at the hip than the reference group did. Calcitriol was associated with a greater risk of hypercalciuria. Both groups sustained less bone loss than the reference group did. Osteoporosis is a well-known complication of cardiac transplantation. 1 Rapid bone loss is reported consistently during the first year after transplantation. 2 – 5 The prevalence of fractures ranges from 22 to 44 percent among cardiac-transplant recipients, 6 – 9 and the incidence of vertebral fractures during the first three years after transplantation ranges from 18 to 35 percent. 10 , 11 We conducted an interventional study with the aim of preventing bone loss after heart transplantation. We judged that the previously reported high rates of fracture necessitated a study comparing two active agents. We selected calcitriol and the bisphosphonate alendronate, which have both been shown to . . .