Susan L. Greenspan, MD; Ronald D. Emkey, MD; Henry G. Bone, MD; Stuart R. Weiss, MD; Norman H. Bell, MD; Robert W. Downs, MD; Clark McKeever, MD; Sam S. Miller, MD; Michael Davidson, MD; Michael A. Bolognese, MD, PC; Anthony L. Mulloy, PhD, DO; Norman Heyden, RPh, MS; Mei Wu, MS; Amarjot Kaur, PhD; Antonio Lombardi, MD
Grant Support: By a grant from Merck Research Laboratories, Rahway, New Jersey, to the individual study sites.
Requests for Single Reprints: Susan L. Greenspan, MD, University of Pittsburgh, Osteoporosis Prevention and Treatment Center, Kaufmann Medical Building, Suite 1110, 3471 Fifth Avenue, Pittsburgh, PA 15213; e-mail, GriffithsD@msx.dept-med.pitt.edu.
Current Author Addresses: Dr. Greenspan: University of Pittsburgh, Osteoporosis Prevention and Treatment Center, Kaufmann Medical Building, Suite 1110, 3471 Fifth Avenue, Pittsburgh, PA 15213.
Dr. McKeever: Touch Research Inc., 800 Gessner, Suite 200, Houston, TX 77024.
Dr. Miller: SAM Clinical Research Center, 7711 Louis Pasteur, Suite 300, San Antonio, TX 78229.
Dr. Weiss: San Diego Endocrine and Medical Clinic, 5920 Friars Road, Suite 208, San Diego, CA 92108.
Dr. Emkey: Radiant Research Reading, 1235 Penn Avenue, Suite 200, Wyomissing, PA 19610.
Dr. Downs: Virginia Commonwealth University, 1101 E. Marshall Street, 7-015, Richmond, VA 23298-0111.
Dr. Bell: Medical University of South Carolina, Strom Thurmond Building, Room 548, 114 Doughty Street, Charleston, SC 29425.
Dr. Bone: Michigan Bone and Mineral Clinic, 22201 Moross Road, Suite 260, Detroit, MI 48236.
Dr. Davidson: Chicago Center for Clinical Research, 515 North State Street, Suite 2700, Chicago, IL 60610-4324.
Dr. Bolognese: Bethesda Health Research, 10215 Fernwood Road, Suite 40, Bethesda, MD 20817.
Dr. Mulloy: Medical College of Georgia, Section of Endocrinology and Nutrition, 1467 Harper Street, HB-5025, Augusta, GA 30912-3115.
Mr. Heyden and Ms. Wu: Merck Research Laboratories, PO Box 2000, Rahway, NJ 07065.
Dr. Kaur: Merck Research Laboratories, 126 East Lincoln Avenue, RY33-404, Rahway, NJ 07065.
Dr. Lombardi: Merck & Co., Inc., 126 East Lincoln Avenue, RY32-545, Rahway, NJ 07065.
Author Contributions: Conception and design: H.G. Bone, R.W. Downs, S.S. Miller.
Analysis and interpretation of the data: S.L. Greenspan, S.S. Miller, M. Wu.
Drafting of the article: S.L. Greenspan, S.S. Miller.
Critical revision of the article for important intellectual content: S.L. Greenspan.
Final approval of the article: S.L. Greenspan, H.G. Bone, N.H. Bell, R.W. Downs, S.S. Miller, M. Wu.
Provision of study materials or patients: S.L. Greenspan, R.D. Emkey, H.G. Bone, S.R. Weiss, N.H. Bell, R.W. Downs, C. McKeever, S.S. Miller, M. Davidson, M.A. Bolognese, A.L. Mulloy.
Statistical expertise: M. Wu.
Obtaining of funding: S.L. Greenspan.
Administrative, technical, or logistic support: N.H. Bell, N. Heyden.
Collection and assembly of data: S.L. Greenspan, R.D. Emkey, H.G. Bone, S.R. Weiss, N.H. Bell, C. McKeever, S.S. Miller, M. Davidson, M.A. Bolognese, N. Heyden.
Greenspan SL, Emkey RD, Bone HG, Weiss SR, Bell NH, Downs RW, et al. Significant Differential Effects of Alendronate, Estrogen, or Combination Therapy on the Rate of Bone Loss after Discontinuation of Treatment of Postmenopausal Osteoporosis: A Randomized, Double-Blind, Placebo-Controlled Trial. Ann Intern Med. 2002;137:875-883. doi: 10.7326/0003-4819-137-11-200212030-00008
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Published: Ann Intern Med. 2002;137(11):875-883.
Several antiresorptive agents have been shown to increase bone mass and reduce osteoporotic fractures (1-3). Because greater improvements in bone mass in women using therapy are associated with greater reductions in fracture (4, 5), investigators have begun to examine combinations of antiresorptive therapies to achieve more substantial gains in bone mass. Lindsay and colleagues demonstrated that addition of alendronate to hormone replacement therapy in postmenopausal women resulted in greater increases in bone mass than did maintenance of estrogen therapy alone (6). We previously showed that administration of alendronate and estrogen for 2 years in postmenopausal women with low bone mass resulted in statistically significantly greater increases in bone mass at the lumbar spine and femoral neck than those seen in women taking either agent alone (7). Furthermore, combination therapy was safe and resulted in normal findings on histologic examination of bone.
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Endocrine and Metabolism, Metabolic Bone Disorders.
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