Characteristics Associated with Bone Mineral Density Responses to Alendronate in Men

• Published in: Calcified tissue international Vol. 92; no. 6; pp. 548 - 556
• Main Authors: Swenson, Erik D., Hansen, Karen E., Jones, Andrea N., Li, Zhanhai, Baltz-Ward, Brooke, Schuna, Arthur A., Elliott, Mary E.
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.06.2013; Springer Nature B.V
• Subjects: Absorptiometry, Photon; Age Factors; Aged; Alendronate - therapeutic use; Biochemistry; Biomedical and Life Sciences; Body Weight; Bone density; Bone Density - drug effects; Bone Density Conservation Agents - therapeutic use; Cell Biology; Clinical outcomes; Drug therapy; Endocrinology; Hip - diagnostic imaging; Humans; Life Sciences; Lumbar Vertebrae - diagnostic imaging; Male; Mens health; Original Research; Orthopedics; Osteoporosis; Osteoporosis - prevention & control; Prescription drugs; Retrospective Studies; Adherence; Osteoporosis; Efficacy; Treatment; Men
• ISSN: 0171-967X; 1432-0827
• DOI: 10.1007/s00223-013-9715-9

Some patients experience reduced bone mineral density (BMD) despite bisphosphonate therapy. We performed a retrospective chart review study to detect factors associated with decreased BMD in men prescribed alendronate. Two investigators reviewed eligible medical records and used a standardized form to record potential characteristics predicting men’s response to alendronate. We analyzed patient characteristics associated with annualized change in hip and spine BMD (D-BMD). Among 115 eligible men, 19 (17 %) experienced significantly decreased BMD at the hip or spine, defined as a change exceeding precision error. Eleven men (10 %) fractured during therapy. Spine D-BMD was positively associated with adherence to alendronate ( R  = 0.23, p  = 0.02) and inversely associated with baseline body weight ( R  = −0.21, p  = 0.03). Hip D-BMD was positively associated with annualized weight change ( R  = 0.19, p  = 0.0498) and negatively associated with patient age and number of concomitant medications ( R  = −0.21, p  = 0.03; R  = −0.20, p  = 0.03, respectively). In stepwise linear models, spine D-BMD was associated positively with alendronate adherence and multivitamin use and negatively with baseline body weight. Hip D-BMD was negatively associated with age. Fracture during treatment was associated with fracture prior to therapy ( p  = 0.03). In this small study of men prescribed alendronate, BMD response showed a positive association with adherence to therapy, weight gain, and use of a multivitamin. By contrast, older age, higher baseline body weight, and higher number of medications were each associated with a decrease in BMD. Larger studies are needed to confirm and extend these findings.