Osteoporosis in men can be treated with bisphosphonates, a study has found. Treatment with alendronate significantly increased spine and hip bone mineral density, reported Dr Eric Orwoll (Oregon Health Sciences university, US) and colleagues at the American Society of Bone and Mineral research meeting in St Louis, US.
The incidence of fractures in men taking alendronate, relative to those in the placebo group, was consistent with the reduction in fractures seen in postmenopausal women taking alendronate, the researchers say. They conclude that the study provides the first documentation of a widely available treatment for osteoporotic men.
Dr Roger Francis (consultant physician, Freeman hospital, Newcastle upon Tyne), who heard the trial data being presented at the meeting, told The Journal on October 13 that he gave the results a "cautious welcome". He said the trial was well designed and was the first big study of osteoporosis in men. Alendronate had led to good results with regard to changes in bone density, suggesting that it worked in a predictable manner in both sexes. Although there was no statistically significant reduction in fractures, the results also indicated a trend in the reduction of vertebral fractures, he said. This was important because changes in bone density did not always equate to reductions in fractures. Data to confirm a reduction in fractures was needed, so further trials of alendronate in men would be required.
Dr Francis had had some experience of clinical use of bisphosphonates in men with osteoporosis. Treatment had resulted in increases in bone density so the trial data were not unexpected, he said.
Another treatment option for osteoporosis in men could lie with testosterone. Dr Francis said that it was known that in men with hypogonadism (who had low levels of testosterone), testosterone replacement therapy increased bone density. However, in men with osteoporosis who had normal testosterone levels, it was not known if additional testosterone supplementation increased bone density. Observational data suggested that it did, and a randomised, controlled trial was about to start at six centres in the UK to confirm its efficacy. Results were expected in 2003, he said.