CYCLICAL CLODRONATE IS EFFECTIVE IN PREVENTING POSTMENOPAUSAL BONE LOSS - A COMPARATIVE-STUDY WITH TRANSCUTANEOUS HORMONE REPLACEMENT THERAPY

An investigative study was carried out for 2 years involving 124 rando mly selected early postmenopausal women with spine bone mineral densit y (BMD) below the mean value of a normal premenopausal subject. After random division into three groups, the first 42 patients were treated with transcutaneous 17-beta-estradiol (50 mu g daily), the second 42 w ere treated with cyclical intravenous clodronate (200 mg/month iv infu sion), and the third group of 40 (controls) was left untreated. After 2 years, the total drop in BMD within the control group was more than 7% as opposed to the values of -0.14% +/- 0.93 in the estradiol group and 0.67% +/- 0.84 in the clodronate group. A change in BMD of < 1% wa s considered satisfactory, and this result was obtained in 32% of the controls, in 79% of the estradiol group where the percentage change in BMD moderately correlated with serum estradiol levels (r = 0.399), an d in 90% of the clodronate-treated patients, in whom the percentage ch ange in BMD inversely correlated with basal values of markers of bone turnover. Both estrogen and clodronate prevent postmenopausal bone los s. The response to transcutaneous hormone replacement therapy may be i nfluenced by transcutaneous absorption and by a lower sensitivity to e strogen. Response to cyclical clodronate seems to be influenced by the rate of bone turnover. An interdosage interval ranging from 2-4 weeks appears suitable for most patients.