One versus 2 years of alendronate following denosumab: the CARD extension
Authors' conclusion
With the limitations of our small sample size, these data suggest that both 1 and 2 years of alendronate effectively maintain BMD gains achieved with 1 year of denosumab and prevented any rebound in bone turnover marker levels above pre-denosumab baseline.
Study context
- Population
- Postmenopausal osteoporotic women aged 60–79 at high fracture risk who received 12 months of denosumab followed by 12 months of alendronate
- Participants
- 10 vs 8
- Comparison
- Alendronate for an additional 12 months vs calcium and vitamin D alone, after 12 months of denosumab and 12 months of alendronate
- Alendronaten = 10
- Calcium/vitamin Dn = 8reference
- Primary endpoint
- Change in spine bone mineral density (BMD) between months 24 and 36
- Follow-up
- Months 24-36
Methodological detailsextension study of the CARD trial
- Extension study of the CARD trial
Primary result
As reported in the abstract
Spine BMD, months 24-36 · month 36
- Areal BMD (aBMD) maintained at the spine in both groups
Further findings
| Outcome | P value |
|---|---|
| Transient comparative decrease in aBMD in calcium/vitamin D group, months 24-30Calcium/vitamin D vs Alendronate · total hip | P = 0.008 |
| Transient comparative decrease in aBMD in calcium/vitamin D group, months 24-30Calcium/vitamin D vs Alendronate · femoral neck | P = 0.040 |
| Increase in bone turnover markers (CTX, P1NP), months 24-36 (exploratory)Calcium/vitamin D vs Alendronate · greater increase in calcium/vitamin D group | P = 0.051 for CTX |
| Increase in bone turnover markers (CTX, P1NP), months 24-36 (exploratory)Calcium/vitamin D vs Alendronate · greater increase in calcium/vitamin D group | P = 0.030 for P1NP |
- Increase in bone turnover markers (CTX, P1NP), months 24-36 (exploratory) — CTX and PINP remained below month 0 baseline in both groups
- P < 0.05 for all comparisons
Total hip and femoral neck aBMD (exploratory) · months 24-36
- aBMD maintained at total hip and femoral neck in both groups
Original publication
One versus 2 years of alendronate following denosumab: the CARD extension. Osteoporos Int. Published 7 August 2024. doi:10.
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