Sequential therapy with abaloparatide, alendronate cuts fracture risk in older women

A strategy of administering abaloparatide for 18 months followed by 24 months of alendronate holds fracture risk at bay in older postmenopausal women with osteoporosis, as shown in a study.

The safety and efficacy of 18-month abaloparatide treatment for reducing osteoporotic fracture risk and increasing bone mineral density were demonstrated in the ACTIVE trial. These effects were maintained with 24 months of alendronate use in ACTIVExtend.

Researchers then conducted a posthoc analysis of ACTIVExtend to determine the effect of sequential treatment with abaloparatide then alendronate on fracture risk and bone mineral density in the subgroup of women with osteoporosis aged ≥80 years.

A total of 56 elderly women participated in ACTIVE, and 46 of them completed the ACTIVExtend study. Their mean age was 83.3 years. By the end of abaloparatide therapy, bone mineral density increased at all sites as compared with placebo. This parameter further increased in both groups during alendronate therapy (19–43 months) in ACTIVExtend.

At month 43, mean percent change in bone mineral density from baseline was 17.2 percent with abaloparatide/alendronate vs 8.6 percent with placebo/alendronate at the lumbar spine (p<0.0001); 5.3 percent vs 3.0 percent, respectively, at the total hip (p=0.024); and 4.6 percent vs 3.1 percent, respectively, at the femoral neck (p=0.044).

There were a few women who developed a fracture, and the proportion did not differ significantly between groups.

Sequential treatment with abaloparatide followed by alendronate was well tolerated. The incidence of adverse events was similar across the treatment groups.