Key result
Alendronate significantly slowed the progression of aortic stenosis, with a decrease in aortic valve area of 0.09 cm2 compared to 0.23 cm2 in the non-treated group over 20 months.
Why the study?
Aortic stenosis is the most common primary valvular disease, but currently no pharmacological approach exists for its medical management.
Does alendronate 70 mg weekly slow down hemodynamic progression and improve NT-pro-BNP levels in women >60 years old with aortic stenosis and concurrent osteoporosis?
Observational (n=70)
Single-blind
No
Does alendronate 70 mg weekly slow down hemodynamic progression and improve NT-pro-BNP levels in women >60 years old with aortic stenosis and concurrent osteoporosis?
Effect estimate: MD 0.129 (95% CI 0.054-0.204)
Absolute Event Rate: -0.09% vs -0.23%
p-value: p=0.001
Alendronate therapy may slow the hemodynamic progression of aortic stenosis and improve NT-pro-BNP levels in older women with concurrent osteoporosis.
May slow aortic stenosis progression in older women with osteoporosis; leaves open randomized confirmation of benefit.
Background: Aortic stenosis (AS) is the most common primary valvular disease. Currently, there is no pharmacological approach for the medical management of AS. We investigated the effect of osteoporosis therapy with alendronate on hemodynamic progression in patients concurrently affected by AS and osteoporosis. Materials and Methods: In this observational prospective study, we enrolled 37 women more than 60 years old with diagnosis of AS and concurrent osteoporosis from August 2017 to December 2019. These patients were treated with alendronate 70 mg every week added to their routine treatment for AS, and their outcomes were compared with 33 patients only affected by AS. Echocardiographic changes and N-terminal-prohormone of brain natriuretic peptide (NT-pro-BNP) level were evaluated during about 2 years of follow-up. Results: The mean follow-up time for the treated and nontreated groups was 20.89 ± 2.73 and 20.84 ± 2.76 months, respectively. Mean gradient (P = 0.02) and peak gradient (P = 0.04) of aortic valve were significantly different between the groups after follow-up. Aortic valve area was decreased 0.09 cm2 in the treated group by alendronate and 0.23 cm2 in the other group (P = 0.001). Furthermore, NT-pro-BNP was significantly decreased in patients treated by alendronate (P = 0.01), but it was increased in nontreated patients (P = 0.04). Conclusion: Treatment with alendronate in patients with AS and concurrent osteoporosis slows down the progression of stenosis and improves their prognosis. This study could open a new pathway for the treatment of AS. Further studies, particularly randomized controlled clinical trial, should be done for providing more evidence.
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Farahani et al. (2020) conducted an observational in Aortic stenosis and concurrent osteoporosis (n=70). Alendronate vs. Routine treatment for aortic stenosis (no bisphosphonates) was evaluated on Change in aortic valve area (delta-AVA) in cm2 (MD 0.129, 95% CI 0.054-0.204, p=0.001). Alendronate significantly slowed the progression of aortic stenosis, with a decrease in aortic valve area of 0.09 cm2 compared to 0.23 cm2 in the non-treated group over 20 months.
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