Comparison of Alendronate vs Alendronate Plus Mechanical Loading as Prophylaxis for Osteoporosis in Lung Transplant Recipients

a Pilot Study

Randy W. Braith, Jill A. Conner, Michael N. Fulton, Clem F. Lisor, Darren P. Casey, Kathy S. Howe, Maher A. Baz

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Background: Osteoporosis is known to complicate outcomes after lung transplantation (Tx). Methods: To determine the efficacy of bisphosphonate therapy combined with the osteogenic stimulus of mechanical loading, 30 lung transplant recipients (LTRs) were randomly assigned either to alendronate (10 mg/day; n = 10), alendronate (10 mg/day) + resistance exercise (n = 10) or to a control group (n = 10). Alendronate was initiated at 7 days after Tx. Bone mineral density (BMD) of the lumbar spine was measured by dual-energy X-ray absorptiometry before and 2 and 8 months after Tx. Resistance training was initiated at 2 months after Tx and consisted of lumbar extension exercise performed 1 day/week for 6 months. Results: Lumbar BMD decreased significantly to below pre-transplant baseline at 2 months after Tx in controls (-12.5 ± 2.1%), but not in the alendronate (1.5 ± 1.2%) or alendronate + training (1.5 ± 0.9%) groups. At 8 months after Tx, lumbar BMD in controls was 14.1 ± 3.9% below baseline (p ≤ 0.05), but was 1.4 ± 1.1% above baseline in alendronate recipients (p ≥ 0.05). The alendronate + training group showed a significantly increased lumbar BMD with values 10.8 ± 2.3% greater than before Tx. Conclusions: These results suggest that resistance exercise plus alendronate is more effective than alendronate alone in restoring BMD. Anti-osteoporosis therapy in LTRs should include both an anti-resorptive agent and an osteogenic stimulus, such as mechanical loading.

Original languageEnglish (US)
Pages (from-to)132-137
Number of pages6
JournalJournal of Heart and Lung Transplantation
Volume26
Issue number2
DOIs
StatePublished - Feb 2007
Externally publishedYes

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Alendronate
Osteoporosis
Lung
Bone Density
Exercise
Transplant Recipients
Resistance Training
Lung Transplantation
Photon Absorptiometry
Diphosphonates
Spine
Transplants
Control Groups

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Transplantation

Cite this

Comparison of Alendronate vs Alendronate Plus Mechanical Loading as Prophylaxis for Osteoporosis in Lung Transplant Recipients : a Pilot Study. / Braith, Randy W.; Conner, Jill A.; Fulton, Michael N.; Lisor, Clem F.; Casey, Darren P.; Howe, Kathy S.; Baz, Maher A.

In: Journal of Heart and Lung Transplantation, Vol. 26, No. 2, 02.2007, p. 132-137.

Research output: Contribution to journalArticle

Braith, Randy W. ; Conner, Jill A. ; Fulton, Michael N. ; Lisor, Clem F. ; Casey, Darren P. ; Howe, Kathy S. ; Baz, Maher A. / Comparison of Alendronate vs Alendronate Plus Mechanical Loading as Prophylaxis for Osteoporosis in Lung Transplant Recipients : a Pilot Study. In: Journal of Heart and Lung Transplantation. 2007 ; Vol. 26, No. 2. pp. 132-137.
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title = "Comparison of Alendronate vs Alendronate Plus Mechanical Loading as Prophylaxis for Osteoporosis in Lung Transplant Recipients: a Pilot Study",
abstract = "Background: Osteoporosis is known to complicate outcomes after lung transplantation (Tx). Methods: To determine the efficacy of bisphosphonate therapy combined with the osteogenic stimulus of mechanical loading, 30 lung transplant recipients (LTRs) were randomly assigned either to alendronate (10 mg/day; n = 10), alendronate (10 mg/day) + resistance exercise (n = 10) or to a control group (n = 10). Alendronate was initiated at 7 days after Tx. Bone mineral density (BMD) of the lumbar spine was measured by dual-energy X-ray absorptiometry before and 2 and 8 months after Tx. Resistance training was initiated at 2 months after Tx and consisted of lumbar extension exercise performed 1 day/week for 6 months. Results: Lumbar BMD decreased significantly to below pre-transplant baseline at 2 months after Tx in controls (-12.5 ± 2.1{\%}), but not in the alendronate (1.5 ± 1.2{\%}) or alendronate + training (1.5 ± 0.9{\%}) groups. At 8 months after Tx, lumbar BMD in controls was 14.1 ± 3.9{\%} below baseline (p ≤ 0.05), but was 1.4 ± 1.1{\%} above baseline in alendronate recipients (p ≥ 0.05). The alendronate + training group showed a significantly increased lumbar BMD with values 10.8 ± 2.3{\%} greater than before Tx. Conclusions: These results suggest that resistance exercise plus alendronate is more effective than alendronate alone in restoring BMD. Anti-osteoporosis therapy in LTRs should include both an anti-resorptive agent and an osteogenic stimulus, such as mechanical loading.",
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AU - Braith, Randy W.

AU - Conner, Jill A.

AU - Fulton, Michael N.

AU - Lisor, Clem F.

AU - Casey, Darren P.

AU - Howe, Kathy S.

AU - Baz, Maher A.

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N2 - Background: Osteoporosis is known to complicate outcomes after lung transplantation (Tx). Methods: To determine the efficacy of bisphosphonate therapy combined with the osteogenic stimulus of mechanical loading, 30 lung transplant recipients (LTRs) were randomly assigned either to alendronate (10 mg/day; n = 10), alendronate (10 mg/day) + resistance exercise (n = 10) or to a control group (n = 10). Alendronate was initiated at 7 days after Tx. Bone mineral density (BMD) of the lumbar spine was measured by dual-energy X-ray absorptiometry before and 2 and 8 months after Tx. Resistance training was initiated at 2 months after Tx and consisted of lumbar extension exercise performed 1 day/week for 6 months. Results: Lumbar BMD decreased significantly to below pre-transplant baseline at 2 months after Tx in controls (-12.5 ± 2.1%), but not in the alendronate (1.5 ± 1.2%) or alendronate + training (1.5 ± 0.9%) groups. At 8 months after Tx, lumbar BMD in controls was 14.1 ± 3.9% below baseline (p ≤ 0.05), but was 1.4 ± 1.1% above baseline in alendronate recipients (p ≥ 0.05). The alendronate + training group showed a significantly increased lumbar BMD with values 10.8 ± 2.3% greater than before Tx. Conclusions: These results suggest that resistance exercise plus alendronate is more effective than alendronate alone in restoring BMD. Anti-osteoporosis therapy in LTRs should include both an anti-resorptive agent and an osteogenic stimulus, such as mechanical loading.

AB - Background: Osteoporosis is known to complicate outcomes after lung transplantation (Tx). Methods: To determine the efficacy of bisphosphonate therapy combined with the osteogenic stimulus of mechanical loading, 30 lung transplant recipients (LTRs) were randomly assigned either to alendronate (10 mg/day; n = 10), alendronate (10 mg/day) + resistance exercise (n = 10) or to a control group (n = 10). Alendronate was initiated at 7 days after Tx. Bone mineral density (BMD) of the lumbar spine was measured by dual-energy X-ray absorptiometry before and 2 and 8 months after Tx. Resistance training was initiated at 2 months after Tx and consisted of lumbar extension exercise performed 1 day/week for 6 months. Results: Lumbar BMD decreased significantly to below pre-transplant baseline at 2 months after Tx in controls (-12.5 ± 2.1%), but not in the alendronate (1.5 ± 1.2%) or alendronate + training (1.5 ± 0.9%) groups. At 8 months after Tx, lumbar BMD in controls was 14.1 ± 3.9% below baseline (p ≤ 0.05), but was 1.4 ± 1.1% above baseline in alendronate recipients (p ≥ 0.05). The alendronate + training group showed a significantly increased lumbar BMD with values 10.8 ± 2.3% greater than before Tx. Conclusions: These results suggest that resistance exercise plus alendronate is more effective than alendronate alone in restoring BMD. Anti-osteoporosis therapy in LTRs should include both an anti-resorptive agent and an osteogenic stimulus, such as mechanical loading.

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