***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Abstract : Serum CrossLaps is a new assay for measuring carboxy-terminal collagen crosslinks ( CTX ) in serum . This measurement is reported to be more specific to bone resorption than other measurements . However , the utility of this and other markers in monitoring patients on antiresorptive therapy depends on how often changes anticipated with therapy exceed changes attributable to r and om variability . In a study where subjects received either placebo or pamidronate , we calculated the minimum significant change ( MSC ) , that is , the change that was sufficiently large that it was unlikely to be due to spontaneous variability . We also examined the changes in markers of bone turnover in subjects treated with pamidronate ( APD ) ( 30 mg I.V. in 500 ml D5W over 4 hours ) to see how often observed changes in turnover after treatment exceeded the MSC . The MSC for serum CTX was 30.2 % , and was significantly ( P < 0.05 ) lower than the MSC for urinary NTX ( 54.0 % ) , and not significantly different from the MSC of urinary DPD ( 20.6 % ) . Ninety percent of subjects treated with APD had a decline in serum CTX that exceeded the MSC , compared with 74 % for bone-specific alkaline phophatase ( BSAP ) , 57 % for urinary N-telopeptide cross-links ( NTX ) , and 48 % for free deoxypyridinoline . Changes in serum CTX correlated reasonably well with changes in spine BMD after 2 years ( r = 0.47 ) , but this correlation did not quite reach statistical significance because of the small number of subjects . In conclusion , the serum CTX assay shows greater utility for assessing efficacy of antiresorptive treatment than some previously described markers Biochemical markers of bone turnover have been suggested to be useful in monitoring the efficacy of antiresorptive therapy . In this study , we investigated the predictive value of bone turnover markers to determine short-term response in bone mineral density ( BMD ) and to identify nonresponders in 138 postmenopausal women ( mean age 58 years ) with osteoporosis given with either hormone thearpy ( HT ) or alendronate .  Urinary type I collagen N-telopeptide ( NTx ) and serum osteocalcin ( OC ) at baseline , 3 , and 6 months after treatment as well as spine and femoral neck BMD at baseline and 12 months were measured . Significant decreases in both NTx and OC were evident in women on treatment with antiresorptive agents as early as 3 months ( p<0.01 ) . Percent change of NTx at 3 months correlated with the percent change of spinal BMD at 12 months of treatment . When bone turnover markers were stratified by tertiles , the average rate of lumbar spine BMD gain increased significantly with increasing tertiles of baseline value ( p<0.05 ) and percent change ( p<0.05 ) of urinary NTx at 3 month of treatment . In terms of BMD response , urinary NTx at 3 months decreased significantly more in BMD responders group than in nonresponders group . Logistic regression analysis demonstrated that percent change of NTx at 3 months is an independent predictor to identify BMD nonresponders , defined as those whose BMD gain remained within the precision error range of dual energy X-ray absorptiometer ( DXA ) . We conclude that biochemical markers of bone turnover , especially percent change in urinary NTx levels , can be used to determine BMD response to antiresorptive therapy in Korean postmenopausal women with osteoporosis UNLABELLED Oral daily ( 2.5 mg ) and intermittent ib and ronate ( between-dose interval of > 2 months ) , delivering a similar cumulative exposure , were evaluated in 2946 osteoporotic women with prevalent vertebral fracture . Significant reduction in incident vertebral fracture risk by 62 % and 50 % , respectively , was shown after 3 years . This is the first study to prospect ively show antifracture efficacy for the intermittent administration of a bisphosphonate . INTRODUCTION Bisphosphonates are important therapeutics in postmenopausal osteoporosis . However , they are currently associated with stringent dosing instructions that may impair patient compliance and hence therapeutic efficacy . Less frequent , intermittent administration may help to overcome these deficiencies . This study assessed the efficacy and safety of oral ib and ronate administered either daily or intermittently with a dose-free interval of > 2 months . MATERIAL S AND METHODS This r and omized , double-blind , placebo-controlled , parallel-group study enrolled 2946 postmenopausal women with a BMD T score < or = -2.0 at the lumbar spine in at least one vertebra ( L1-L4 ) and one to four prevalent vertebral fractures ( T4-L4 ) . Patients received placebo or oral ib and ronate administered either daily ( 2.5 mg ) or intermittently ( 20 mg every other day for 12 doses every 3 months ) . RESULTS AND CONCLUSIONS After 3 years , the rate of new vertebral fractures was significantly reduced in patients receiving oral daily ( 4.7 % ) and intermittent ib and ronate ( 4.9 % ) , relative to placebo ( 9.6 % ) . Thus , daily and intermittent oral ib and ronate significantly reduced the risk of new morphometric vertebral fractures by 62 % ( p = 0.0001 ) and 50 % ( p = 0.0006 ) , respectively , versus placebo . Both treatment groups also produced a statistically significant relative risk reduction in clinical vertebral fractures ( 49 % and 48 % for daily and intermittent ib and ronate , respectively ) . Significant and progressive increases in lumbar spine ( 6.5 % , 5.7 % , and 1.3 % for daily ib and ronate , intermittent ib and ronate , and placebo , respectively , at 3 years ) and hip BMD , normalization of bone turnover , and significantly less height loss than in the placebo group were also observed for both ib and ronate regimens . The overall population was at low risk for osteoporotic fractures . Consequently , the incidence of nonvertebral fractures was similar between the ib and ronate and placebo groups after 3 years ( 9.1 % , 8.9 % , and 8.2 % in the daily , intermittent , and placebo groups , respectively ; difference between arms not significant ) . However , findings from a posthoc analysis showed that the daily regimen reduces the risk of nonvertebral fractures ( 69 % ; p = 0.012 ) in a higher-risk subgroup ( femoral neck BMD T score < -3.0 ) . In addition , oral ib and ronate was well tolerated . Oral ib and ronate , whether administered daily or intermittently with an extended between-dose interval of > 2 months , is highly effective in reducing the incidence of osteoporotic fractures in postmenopausal women . This is the first time that significant fracture efficacy has been prospect ively shown with an intermittently administered bisphosphonate in the overall study population of a r and omized , controlled clinical trial . Thus , oral ib and ronate holds promise as an effective and convenient alternative to current bisphosphonate therapies The purpose of this study was to determine factors that could predict the one-year response of the lumbar bone mineral density ( BMD ) to alendronate treatment in elderly Japanese women with osteoporosis . Eighty-five postmenopausal women with osteoporosis , all of whom were between 55 - 88 years of age , were treated with alendronate ( 5 mg daily ) for 12 months . Serum calcium , phosphorus , and alkaline phosphatase ( ALP ) and urinary NTX levels were measured at the baseline and 6 months , and lumbar ( L1-L4 ) BMD was measured by dual energy X-ray absorptiometry at the baseline and 12 months . Multiple regression analysis was used to determine factors that were correlated with the percent change in lumbar BMD at 12 months . Lumbar BMD increased by 8.1 % at 12 months with a reduction in the urinary NTX level by 51.0 % at 6 months . Baseline lumbar BMD ( R2=0.226 , p < 0.0001 ) and percent changes in serum ALP and urinary NTX levels ( R2=0.044 , p < 0.05 and R2=0.103 , p < 0.001 , respectively ) had a negative correlation with the percent change in lumbar BMD at month 12 , while the baseline number of prevalent vertebral fractures ( R2=0.163 , p < 0.001 ) , serum ALP level , and urinary NTX level ( R2=0.074 , p < 0.05 and R2=0.160 , p < 0.001 , respectively ) had a positive correlation with it . However , baseline age , height , body weight , body mass index , years since menopause , serum calcium and phosphorus levels , and percent changes in serum calcium and phosphorus levels at 6 months did not have any significant correlation with the percent change in lumbar BMD at 12 months . These results suggest that lumbar BMD was more responsive to one-year of alendronate treatment in elderly osteoporotic Japanese women with lower lumbar BMD , more prevalent vertebral fractures , and higher bone turnover , who showed a greater decrease in bone turnover at 6 months , regardless of age , years since menopause , and physique . Alendronate may be efficacious in elderly Japanese women with evident osteoporosis that is associated with high bone turnover , and the percent changes in serum ALP and urinary NTX levels at 6 months could predict the one-year response of lumbar BMD to alendronate treatment UNLABELLED The relationship between early changes in biochemical markers of bone turnover and the subsequent BMD response to daily teriparatide therapy in women with postmenopausal osteoporosis was studied . Changes in five biochemical markers , obtained from a subset of women enrolled in the Fracture Prevention Trial , were examined . Early increases in the PICP and the PINP were the best predictors of BMD response to teriparatide in this analysis . INTRODUCTION Early reductions in biochemical markers of bone turnover with antiresorptive therapy negatively correlate with subsequent increases in BMD . We undertook this analysis to determine if early changes in biochemical markers with teriparatide therapy predict subsequent increases in BMD . MATERIAL S AND METHODS In the Fracture Prevention Trial , 1637 postmenopausal women with osteoporosis were r and omized to receive daily , self-administered , subcutaneous injections of placebo , teriparatide 20 microg/day , or teriparatide 40 microg/day . Serum concentrations of two bone formation markers ( bone-specific alkaline phosphatase [ bone ALP ] and the carboxy-terminal extension peptide of procollagen type 1 [ PICP ] ) and urinary concentrations of two bone resorption markers ( free deoxypyridinoline [ DPD ] and N-terminal telopeptide [ NTX ] ) were assessed in a trial population subset ( n = 520 ) at baseline and at 1 , 3 , 6 , and 12 months . We also assessed serum concentrations of another bone formation marker , the amino-terminal extension peptide of procollagen type 1 ( PINP ) , in a subset of 771 women at baseline and 3 months . Lumbar spine ( LS ) BMD was measured by DXA at baseline and 18 months . Femoral neck BMD was measured at baseline and 12 months . RESULTS AND CONCLUSION Baseline bone turnover status correlated positively and significantly with BMD response . The highest correlations occurred for the LS BMD response to teriparatide 20 microg/day . Among all studied biochemical markers , increases in PICP at 1 month and PINP at 3 months correlated best with increases in LS BMD at 18 months ( 0.65 and 0.61 , respectively ; p < 0.05 ) . The relationships between these two biochemical markers and the LS BMD response were stronger than the corresponding relationships for the femoral neck BMD response . Using receiver operator curve analysis , we determined that the increases in PICP at 1 month and PINP at 3 months were the most sensitive and accurate predictors of the LS BMD response Summary A r and omized controlled trial was performed to compare the short-term effects of alendronate ( ALN ) and ECT on pain and quality of life ( QOL ) in postmenopausal women with osteoporosis .  Back pain and QOL [ Short-Form Health Survey ( SF-8 ) ] significantly improved at 1 , 3 , and 6 months in both groups , with greater improvements in the ALN group than in the ECT group . These results suggested that ALN reduced back pain and improved QOL more markedly than ECT in postmenopausal osteoporotic women with back pain . Introduction Intramuscular ECT is known to reduce pain via the central nervous system . A multicenter r and omized controlled trial was performed to compare the short-term effects of ALN and ECT on pain and QOL in postmenopausal women with osteoporosis . Methods One hundred and 94 postmenopausal osteoporotic women with back pain ( mean age 79.8 years , range 60–96 years ) were r and omly divided into two groups : the ALN group ( 35 mg weekly ) and the ECT group ( intramuscular 
    Output:
    
There was insufficient evidence to inform the choice of which bone turnover marker to use in routine clinical practice to monitor osteoporosis treatment response .