Table 4. Randomized Controlled Trials of Alendronate with Fracture Outcomes

Author Duration (years) Age (years) Population Exclusion Criteria1 Participants Lost to Followup Quality Rating2
Adami, 1995 (103) 2 48-76 9 Italian Centers, T-score <-2 (0.67g/cm2); 5% vertebral fractures Narrow 32/211 (15.2%) Fair to Good
Black, 1996 (104) 3 55-81 11 U.S. cities, BMD <0.68 g/cm2; no previous vertebral fractures Broad (medical illness, dyspepsia, etc.) 81/2,027 (4%) Good
Bone, 1997 (105) 2 >60 15 U.S. sites, BMD <0.84 g/cm2; average 20 yrs since menopause; 30.7% vertebral fractures Broad (medical illness, NSAIDs, GI drugs) 19/359 (5.3%) Fair to Good
Chesnut, 1995 (106) 2 42-75 (avg. 63) 7 centers, spine BMD <0.88, average hip BMD 0.7; >5 years since menopause Broad 26/157 (16.6%) Fair
Cummings, 1998 (107) 4 55-81 11 U.S. cities, BMD <0.68 g/cm2 (ave. 0.59); no previous vertebral fractures Broad (medical illness, dyspepsia) 179/4,432 (4%) Good
Greenspan, 1998 (108) 2.5 >65 1 Boston center, no BMD entry criteria Narrow ("good health") 33/120 (27.5%) Fair
Hosking, 1998 (109) 4 45-59 4 centers, BMD >0.8 g/cm2; <10% prevalent vertebral fractures Narrow ("good health") 287/1,499 (19.1%) Fair
Liberman, 1995 (110) 3 45-80 2 multicenter trials, T-score <-2.5; 21% prevalent vertebral fractures Narrow ("good health") 170/994 (17.1%) Good
McClung, 1998 (111) 3 40-59 15 centers, T-score <-2; 6-36 months since menopause; no previous vertebral fractures Narrow ("good health," estrogen use) 31% at 3 years Fair
Pols, 1999 (112) 1 40-82 153 centers, T-score <-2.8 Narrow ("good health") 211/1,908 (11.1%) Fair

1In general, "narrow" criteria excluded estrogen users and patients with illnesses affecting bone metabolism.
2Based on criteria developed by the U.S. Preventive Services Task Force (22).


Return to Document