Abstract
PURPOSE: Postmenopausal osteoporosis causes bone fracture as well as pain, physical, psychological and socially adverse effects, which affects a patient's quality of life (QOL). The effect of alendronate on QOL was investigated compared with that of alfacalcidol in post-menopausal osteoporotic women. PATIENTS AND METHODS: A total of 44 postmenopausal osteoporotic women (mean age 69.8 years) with back or joint pain, although capable of walking, were randomly assigned to two groups; group A (n=25) received 5 mg/day of alendronate, and group B (n=19) received 0.5 microg/day of alfacalcidol, for the first 4 months. For the following 2 months, the group A received 0.5 microg/day of alfacalcidol and the group B received 5 mg/day of alendronate in a crossover design. The patient's QOL was evaluated by score of Japanese Osteoporosis Quality of Life Questionnaire (JOQOL), and pain intensity using a visual analog scale (VAS). Bone metabolism was measured by bone mineral density (BMD) and a biomarker for bone resorption, urinary crosslinked N-terminal telopeptide of type I collagen (NTX). RESULTS: With 4-month treatment, alendronate, but not alfacalcidol, improved pain-related QOL, reduced joint pain by VAS, and increased bone mineral density. Both treatments significantly reduced bone resorption, the inhibition was significantly higher with alendronate (-56.5%) compared with alfacalcidol (-18.1%). After crossover, the patients in group A received alfacalcidol and had a reduced total and daily living activity-related QOL scores, and increased upper back pain by VAS. The group B received alendronate had significantly reduced bone resorption after the 2 months. CONCLUSION: Alendronate improves the QOL of Japanese postmenopausal women with osteoporosis by reducing pain intensity as well as increasing bone mineral density.