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Fosamax best in bone density test
Study funded by manufacturer, however
A 12 month study to compare the effectiveness of alendronate (Fosamax) and risedronate (Actonel) showed Fosamax increased bone mineral density (BMD) by as much as 62% at sites measured in 520 osteoporotic postmenopausal women. The average age of test subjects was 64 years, and 94% were white.
In all, 1,053 individuals participated in the study, the other 533 subjects were given alendrate.
The subjects were given a dose of 35 mg once per week. After a year, alendronate produced BMD increase of as much as 3.4% compared to 2.1% for risedronate.
The results, released at the 26th annual meeting of the American Society for Bone and Mineral Research (ASBMR), verified a two-year study done earlier. Merck & Company, the manufacturer of alendronate , funded the research.
Those taking alendronate showed an overall increase of 2.2% compared to 2.1% for alendrate in the hip, 1.6%, compared to 0.9% at the femoral neck and 3.7% vs 2.6% in the lumbar spine. Positive increases were noticeable after just six months in most cases.
“Overall, 84.5% of women in the alendronate group gained or maintained BMD at hip trochanter vs 67.8% of women in the alendrate group, and 87.3% of the alendronate-treated women gained or maintained BMD at the lumbar spine vs 75.6% of women in the risedronate group.” According to a report on the study.
“The lead investigator of the Fosamax Actonel Comparison Trial (FACT), Clifford Rosen, MD, from the Maine Center of Osteoporosis Research and Education and St. Joseph Hospital in Bangor, Maine, said, "The density of the gains for alendronate were certainly greater than for ris-edronate, but of equal [importance] and perhaps more im- portantly, there was no increase for gastrointestinal side effects with either agent."
The results are not without it’s doubters, however. Some ASBMR members point to the fact that study was funded by Procter & Gamble and Aventis who market the Fosamax.
Paraskevi Sapountizi, MD, an endocrinologist at Loyola University in Illinois explained that “increased bone mineral density and risk of fracture are two different things.”
"There is no proof at the moment that increased bone density created with the use of bisphosphonates correlates with a reduction in the risk of fractures among people taking the drugs. While some clinicians might use the data in the new study to make a decision on treatment regimens, I think more conservative physicians will await more definitive studies. Certainly, if I had a patient on risedronate and that patient tolerated the drug well and appeared to be showing increases in bone density, I would not change medication, despite the results of this trial," Dr. Sapountzi said.
"Overall, these are both great drugs and I wouldn't trade one for another on the basis of what we now know about their impact on treatment of people with osteoporosis." Dr. Rosen agreed that the study did not look at fracture rates and suggested that it would take a 10,000-patient study to find a difference in that outcome.
