This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Lewiecki, E. M. Articles by Fitzpatrick, L. A. Search for Related Content PubMed PubMed Citation Articles by Lewiecki, E. M. Articles by Fitzpatrick, L. A. Related Collections Calcium and Bone Metabolism Female Endocrinology

Once-Monthly Oral Ibandronate Improves Biomechanical Determinants of Bone Strength in Women with Postmenopausal Osteoporosis

New Mexico Clinical Research & Osteoporosis Center (E.M.L.), Albuquerque, New Mexico 87106; University of California, Berkeley (T.M.K.), Berkeley, California 94720; O. N. Diagnostics (T.M.K., D.L.K.), Berkeley, California 94704; University of California, San Francisco (H.K.G.), San Francisco, California 94143; Synarc, Inc. (H.K.G., T.F.), San Francisco, California 94105; Synarc, Inc., 22087 Hamburg, Germany, and Institute of Medical Physics, University of Erlangen (K.E.), 91054 Erlangen, Germany; Altoona Arthritis and Osteoporosis Center (A.K.), Duncansville, Pennsylvania 16635; and GlaxoSmithKline (R.Y.D., L.A.F.), King of Prussia, Pennsylvania 19406

Address all correspondence & requests for reprints to: E. Michael Lewiecki, M.D., F.A.C.P., F.A.C.E., Osteoporosis Director, New Mexico Clinical Research & Osteoporosis Center, 300 Oak Street NE, Albuquerque, New Mexico 87106. E-mail: lewiecki{at}aol.com.

Context: Bone strength and fracture resistance are determined by bone mineral density (BMD) and structural, mechanical, and geometric properties of bone.

Design, Setting, and Objectives: This randomized, double-blind, placebo-controlled outpatient study evaluated effects of once-monthly oral ibandronate on hip and lumbar spine BMD and calculated strength using quantitative computed tomography (QCT) with finite element analysis (FEA) and dual-energy x-ray absorptiometry (DXA) with hip structural analysis (HSA).

Participants: Participants were women aged 55–80 yr with BMD T-scores –2.0 or less to –5.0 or greater (n = 93).

Intervention: Oral ibandronate 150 mg/month (n = 47) or placebo (n = 46) was administered for 12 months.

Outcome Measures: The primary end point was total hip QCT BMD change from baseline; secondary end points included other QCT BMD sites, FEA, DXA, areal BMD, and HSA. All analyses were exploratory, with post hoc P values.

Results: Ibandronate increased integral total hip QCT BMD and DXA areal BMD more than placebo at 12 months (treatment differences: 2.2%, P = 0.005; 2.0%, P = 0.003). FEA-derived hip strength to density ratio and femoral, peripheral, and trabecular strength increased with ibandronate vs. placebo (treatment differences: 4.1%, P < 0.001; 5.9%, P < 0.001; 2.5%, P = 0.011; 3.5%, P = 0.003, respectively). Ibandronate improved vertebral, peripheral, and trabecular strength and anteroposterior bending stiffness vs. placebo [7.1% (P < 0.001), 7.8% (P < 0.001), 5.6% (P = 0.023), and 6.3% (P < 0.001), respectively]. HSA-estimated femoral narrow neck cross-sectional area and moment of inertia and outer diameter increased with ibandronate vs. placebo (respectively 3.6%, P = 0.003; 4.0%, P = 0.052; 2.2%, P = 0.049).

Conclusions: Once-monthly oral Ibandronate for 12 months improved hip and spine BMD measured by QCT and DXA and strength estimated by FEA of QCT scans.