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- Title
Does a history of non-vertebral fracture identify women without osteoporosis for treatment?
- Authors
Ryder, Kathryn M; Cummings, Steven R.; Palermo, Lisa; Satterfield, Suzanne; Bauer, Douglas C; Feldstein, Adrianne C.; Schousboe, John T.; Schwartz, Ann V.; Ensrud, Kristine; Fracture Intervention Trial Research Group
- Abstract
<bold>Background: </bold>Postmenopausal women with a prior fracture have an increased risk for future fracture. Whether a history of non-vertebral fracture defines a group of women with low bone mass but without osteoporosis for whom alendronate would prevent new non-vertebral fracture is not known.<bold>Subjects and Methods: </bold>Secondary analysis of data from the Fracture Intervention Trial (FIT). Of 2,785 postmenopausal women with a T-score at the femoral neck between -1 and -2.5 and without prevalent radiographic vertebral deformity, 880 (31.6%) reported experiencing a fracture after 45 years of age. Women were randomized to placebo or alendronate (5 mg/day years for the first 2 years and 10 mg/day thereafter) and were followed for an average of 4.2 +/- 0.5 years. Incident non-vertebral fractures were confirmed by x-rays and radiology reports.<bold>Results: </bold>In the placebo arm, a self-report of prior fracture identified women with a 1.5-fold (hazard ratio [RH] 1.46, 95% C.I. 1.04-2.04) increased risk for incident non-vertebral fracture. However, there was no evidence that the effect of alendronate differed across subgroups of women with (RH 1.26 for alendronate vs placebo, 95% C.I. 0.89-1.79) and without prior fracture (RH 1.02 for alendronate vs placebo, 95% C.I. 0.76-1.38; P = 0.37 for interaction).<bold>Conclusion: </bold>Assessing a clinical risk factor, prior non-vertebral fracture, did not identify women with low bone mass for whom alendronate reduced future non-vertebral fracture risk.
- Subjects
OSTEOPOROSIS in women; TREATMENT of fractures; PLACEBOS; FEMUR neck; BONE diseases; BONE fracture prevention; OSTEOPOROSIS prevention; RESEARCH; ALENDRONATE; DIPHOSPHONATES; RESEARCH methodology; EVALUATION research; MEDICAL cooperation; RISK assessment; OSTEOPOROSIS; COMPARATIVE studies; RANDOMIZED controlled trials; CHI-squared test; POSTMENOPAUSE; BLIND experiment; RESEARCH funding; BONE density; PROPORTIONAL hazards models; BONE fractures; DISEASE complications
- Publication
JGIM: Journal of General Internal Medicine, 2008, Vol 23, Issue 8, p1177
- ISSN
0884-8734
- Publication type
journal article
- DOI
10.1007/s11606-008-0622-0