RESEARCH - Fosamax reduces progression of spinal osteophytes and disc-space narrowing

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Alendronate Reduces Progression of Spinal Osteophytes and Disc-Space Narrowing

By Will Boggs, MD

NEW YORK (Reuters Health) Oct 13 - Alendronate slowed the progression

of spinal osteophytes and disc-space narrowing in 200 post-menopausal

patients with osteoarthritis, according to a study reported in the

October issue of the ls of the Rheumatic Diseases.

" While the actual difference in spinal osteophyte and disc-space

narrowing progression was small between the treatment arms, albeit

statistically significant, the clinical relevance is the biologic

demonstration in humans that a bisphosphonate such as alendronate can

indeed have effects on osteophytes and cartilage, " Dr. Tuhina Neogi

from Boston University School of Medicine told Reuters Health.

Dr. Neogi and colleagues examined the effects of alendronate on the

progression of spinal disc degeneration in the patients who received

alendronate or placebo over a 3- to 4-year interval as part of the

Fracture Intervention Trial.

The osteophyte score progressed by an average of 3.2 in the

alendronate group, the authors report, compared with an average change

of 4.7 in the placebo group, reflecting a greater progression of

osteophytes over the course of the trial in the placebo group.

Similarly, the mean change in the disc-space narrowing score at all

disc levels was 0.4 in the alendronate group and 0.7 in the placebo

group, the investigators say, " suggesting that the progression of

disc-space narrowing in the alendronate group was almost half that of

the placebo group, although the difference was not statistically

significant. "

The effects of alendronate treatment on osteophytes and disc-space

narrowing did not differ in women with and without vertebral

fractures, the researchers note.

" Because our study included only those with osteoporosis/osteopenia,

we cannot extrapolate the findings to those without

osteoporosis/osteopenia, " Dr. Neogi said. " It is intriguing, however,

that we found effects not only on spinal osteophytes, but also on

disc-space narrowing, indicating a cartilage effect. "

" This raises further support for continuing to pursue studies of

alendronate, other bisphosphonates, and even other bone-modulating

agents as a potential treatment for osteoarthritis, " Dr. Neogi

concluded.

Ann Rheum Dis 2008;67:1427-1430.

http://www.medscape.com/viewarticle/581965

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