Skeletal benefits of two years of alendronate treatment are similar for early postmenopausal Asian and Caucasian women

Alendronate has been shown to increase bone density among early postmenopau sal women. Osteoporosis is common among both Asian and Caucasian women, but most clinical trials have consisted primarily of Caucasian women, and it d oes not appear that the effectiveness of antiresorptive agents such as alen dronate has been compared between the two races. In this study we compared the response of bone density and biochemical markers to alendronate among 1 36 Asian and 126 Caucasian women who participated in the Early Postmenopaus al Interventional Cohort (EPIC) at the Hawaii center. Approximately 40 wome n of each race were randomly assigned to placebo or to 2.5 mg/day or 5 mg/d ay alendronate. Bone mineral density (BMD) was measured at the spine, total hip and total body at baseline, 12 months and 24 months; biochemical marke rs of bone turnover were measured at 6-month intervals. Responses were grea ter for the 5 mg dose than 2.5 mg, and were similar in the two races. For e xample, mean (SE) changes in spine BMD at 24 months for Caucasians and Asia ns, respectively, were -1.9% (0.5%) and -1.9% (0.4%) for the placebo group, 2.0% (0.5%) and 3.4% (0.5%) at 2.5 mg/day and 4.2% (0.5%) for both races a t 5 mg/day. Corresponding changes in urinary N-telopeptide collagen crossli nks were -33.6% (5.6%) and -27.8% (5.8%) for placebo, -51.4% (4.0%) and -62 .1 (4.3%) at 2.5 mg/day and -70.8% (2.4%) and -73.5% (3.1%) at 5 mg/day. We conclude that (1) the rate of bone loss in untreated Asian and Caucasian p ostmenopausal women is similar, with the possible exception of the hip; (2) 5 mg alendronate daily provides greater skeletal benefits than 2.5 mg/day in both Asian and Caucasian early postmenopausal women; and (3) the respons e at 5 mg/day is similar in the two races.