Effect of Alendronate on HIV-Associated Osteoporosis: A Randomized, Double-Blind, Placebo-Controlled, 96-Week Trial (ANRS 120)
- 1 September 2012
- journal article
- research article
- Published by Mary Ann Liebert Inc in AIDS Research and Human Retroviruses
- Vol. 28 (9), 972-980
- https://doi.org/10.1089/aid.2011.0224
Abstract
Low bone mineral density (BMD) is common in HIV-infected patients. Bisphosphonates such as alendronate potently inhibit bone resorption and are effective against osteoporosis. The aim of the ANRS 120 Fosivir trial was to evaluate the effect of alendronate on low BMD in HIV-infected patients. HIV-1-infected adults with a t-score≤−2.5 at the lumbar spine and/or total hip, as assessed by dual x-ray absorptiometry, and no other known risk factors for low BMD, were randomized to receive either extended-release alendronate 70 mg weekly or placebo for 96 weeks, with stratification for gender. All the patients also received daily calcium carbonate (500 mg) and vitamin D (400 U). The primary endpoint for efficacy was the percentage change in BMD at the site with a t-score≤−2.5. Forty-four antiretroviral-treated patients (42 men, 2 women) were enrolled. The median age was 45 years, the median CD4 cell count was 422/mm3, and viral load was n=20) and placebo (n=24) groups. At baseline, 15 patients (75%) in the alendronate group and 17 patients (71%) in the placebo group had a t-score≤−2.5 at the lumbar spine. In the main analysis, BMD at the site with a t-score≤−2.5 increased by 7.1% and 1.0%, respectively, in the alendronate (n=14) and placebo (n=20) groups at week 96 [mean difference, 6.1% (95% CI 2.8 to 9.3); p=0.0003]. Alendronate 70 mg weekly for 96 weeks improves BMD in HIV-1-infected patients on antiretroviral therapy.Keywords
This publication has 24 references indexed in Scilit:
- Increased Risk of Fragility Fractures among HIV Infected Compared to Uninfected Male VeteransPLOS ONE, 2011
- A double-blinded, randomized controlled trial of zoledronate therapy for HIV-associated osteopenia and osteoporosisAIDS, 2009
- Fracture Prevalence among Human Immunodeficiency Virus (HIV)-InfectedVersusNon-HIV-Infected Patients in a Large U.S. Healthcare SystemJournal of Clinical Endocrinology & Metabolism, 2008
- Reduced bone mineral density in HIV-infected patients: prevalence and associated factorsAIDS, 2008
- Low Bone Mineral Density, HIV Infection, and Women: Fracture or Fiction?Clinical Infectious Diseases, 2006
- Bone Disease and HIV InfectionClinical Infectious Diseases, 2006
- Alendronate Reduces Bone Resorption in HIV-Associated Osteopenia/OsteoporosisHIV Research & Clinical Practice, 2004
- BMD Is Reduced in HIV-Infected Men Irrespective of TreatmentJournal of Bone and Mineral Research, 2004
- Decreased bone mineral density in HIV-infected patients is independent of antiretroviral therapyAIDS, 2003
- Alendronate for the Treatment of Osteoporosis in MenNew England Journal of Medicine, 2000