Does a history of non-vertebral fracture identify women without osteoporosis for treatment?

Kathryn M. Ryder, Steven R. Cummings, Lisa Palermo, Suzanne Satterfield, Douglas C. Bauer, Adrianne C. Feldstein, John T. Schousboe, Ann V. Schwartz, Kristine Ensrud

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

BACKGROUND: 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. SUBJECTS AND METHODS: 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. RESULTS: 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). CONCLUSION: 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.

Original languageEnglish (US)
Pages (from-to)1177-1181
Number of pages5
JournalJournal of general internal medicine
Volume23
Issue number8
DOIs
StatePublished - Aug 2008

Bibliographical note

Funding Information:
Acknowledgments: This research was sponsored by Merck Research Laboratories, Rahway, NJ. Members of the Fracture Intervention Trial Research Group are listed in reference 23.

Keywords

  • Fracture
  • Osteoporosis
  • Women

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