{"id":7875,"date":"2010-02-21T11:11:35","date_gmt":"2010-02-21T11:11:35","guid":{"rendered":"http:\/\/moomango.co.uk\/htb\/?p=7875"},"modified":"2013-07-15T10:35:04","modified_gmt":"2013-07-15T10:35:04","slug":"alendronate-improves-bone-mineral-density-in-hiv-positive-people-with-osteoporosis-at-96-weeks","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/7875","title":{"rendered":"Alendronate improves bone mineral density in HIV positive people with osteoporosis at 96 weeks"},"content":{"rendered":"

Simon Collins, HIV\u00a0i-Base<\/strong><\/p>\n

A small randomised placebo-controlled study (ANRS 120) showed that alendronate therapy (70mg once-weekly) significantly increased bone mineral density\u00a0(BMD) at the osteoporotic site after 96 weeks. All patients also received\u00a0 calcium carbonate 500mg and vitamin D 400 units daily. [1]<\/strong><\/p>\n

Rozenberg and colleagues randomised 44 patients (n=20 alendronate; n=24 placebo)) with T-scores less than \u00962.5 at lumbar spine and\/or total hip assessed by\u00a0DXA. Mean age at baseline was 45 years, CD4 count was 422 cells\/mm3 and 84% had viral load <400 copies\/mL. Only two women were in this study.<\/p>\n

At week 96, BMD increased at the osteoporosis site by 7.1% vs 1.0% in the alendronate and placebo groups respectively [mean difference 6.1% 95%CI 2.8 to\u00a09.3%; p=0.003]. BDM increased by >2.5% in 86% vs 40% in each group respectively. A greater number of adverse events were reported in the placebo group\u00a0(13 vs 6).<\/p>\n

The authors concluded that alendronate improved BMD in HIV positive people using antiretroviral treatment who were diagnosed with osteoporosis.<\/p>\n

COMMENT <\/strong><\/p>\n

While this study confirmed results from an earlier 48-week randomised trial [2], and suggested additional benefits from longer treatment, the\u00a0earlier study should have been sufficient not to require a placebo for any patients with diagnosed osteoporosis. Aledronate is already included in HIV\u00a0guidelines that discuss the management of osteoporosis. <\/strong><\/p>\n

However, until DXA screening is included in routine management, the majority of HIV-positive patients with low bone mineral density are unlikely\u00a0to have their osteoporosis diagnosed unless it becomes symptomatic (ie post-fracture). <\/strong><\/p>\n

The recent EACS monitoring guidelines (November 2009) included the recommendation to use the FRAX online calculator to screen HIV-positive
\npatients.<\/strong><\/p>\n

References<\/p>\n

    \n
  1. Rozenberg S et al. Effect of alendronate on HIV-related osteoporosis: a randomised, double-blind, placebo-controlled trial (ANRS 120). 12th EACS,\u00a011-14 November 2009, Cologne. Abstract PS5\/4.<\/li>\n
  2. McComsey G et al. Alendronate with calcium and vitamin D supplementation is superior to calcium and vitamin D alone in the management of decreased\u00a0bone mineral density in HIV-infected patients: Results of ACTG 5163. 14th CROI, 2007. Oral abstract 42.
    \nhttp:\/\/www.retroconference.org\/2007\/Abstracts\/28458.htm<\/a><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Simon Collins, HIV\u00a0i-Base A small randomised placebo-controlled study (ANRS 120) showed that alendronate therapy (70mg once-weekly) significantly increased bone mineral density\u00a0(BMD) at the osteoporotic site after 96 weeks. All patients also received\u00a0 calcium carbonate 500mg and vitamin D 400 units …<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,8],"tags":[72],"class_list":["post-7875","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-side-effects","tag-eacs-12th-2009"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/7875","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=7875"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/7875\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=7875"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=7875"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=7875"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}