***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 
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    Input: 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 20 units a week ) . The duration of the study was 6 months . The trial was completed in 97 ( 100 % ) women of the ALN group and 96 ( 99.0 % ) women of the ECT group .  Urinary levels of cross-linked N-terminal telopeptide of type I collagen ( NTX ) , serum alkaline phosphatase ( ALP ) , face scale score ( FSS , back pain ) , and SF-8 ( QOL ) were monitored . Results Urinary NTX levels significantly decreased at 3 months in the ALN group , but not in the ECT group . Serum ALP levels significantly decreased at 6 months in the both groups , with a greater reduction in the ALN group . The FSS and 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 . Conclusions ALN suppressed bone turnover , reduced back pain , and improved QOL more markedly than ECT in postmenopausal osteoporotic women with back pain OBJECTIVE To evaluate the efficacy and safety of rhPTH ( 1 - 34 ) vs. elcatonin . METHODS Sixty patients with primary OP were r and omly divided into two groups according to the ratio of 3:1 . rhPTH ( 1 - 34 ) group ( PTH group ) was treated with subcutaneous injection of rhPTH ( 1 - 34 ) 20 μ g daily for 18 months , and the elcatonin group ( CT group ) was treated with intramuscular injection of elcatonin 20 U weekly for 12 months . Bone mineral density ( BMD ) of the lumbar spine 2 - 4 ( L2 - 4 ) and femoral neck , serum calcium and phosphorus , urinary calcium , serum bone specific alkaline phosphatase ( BSAP ) , and urinary c-terminal telopeptides of type I collagen/creatinine ( uCTX-I/Cr ) were tested at baseline , and 6 , 12 , and 18 months after treatment . RESULTS In PTH group , BMD of L2 - 4 at 6 , 12 , and 18 months , BDM of femoral neck at 18 month , BSAP at 6 and 12 months and uCTX- I/Cr at 6 , 12 and 18 months were all significantly raised . In CT group , BMD of L2 - 4 at 12 month and that of femoral neck at 12 and 18 months were significantly elevated , while BSAP was significantly decreased at 12 and 18 months , and no significant difference on CTX- I/Cr was observed . When BMD growth and growth rate between two groups were compared , PTH group had better improvement in L2 - 4 BMD and growth rate than CT group at 6 , 12 , and 18 months . BMD growth and growth rate of femoral neck at 12 month and its growth at 18 month in CT group were higher than in PTH group , but there was no significant difference between two groups regarding the growth rates at 18 month . Besides , there were no significant differences regarding the rates of adverse reactions between two groups . CONCLUSIONS rhPTH ( 1 - 34 ) , is safe and effective in the treatment of primary OP . It is superior to elcatonin in improving vertebral BMD at onset time , growth rate and growth range , but inferior to elcatonin at BMD of femoral neck The aim of this study was to compare the efficacy of elcatonin injections and oral nonsteroidal anti-inflammatory drugs ( NSAIDs ) for patients with osteoporosis who have acute lumbar pain after experiencing new vertebral compression fractures . Two hundred twenty-eight Japanese female patients ( mean age 77.3 years ) with acute lumbar pain from osteoporotic vertebral fractures were r and omly divided into two groups . Patients in one group were given an NSAID ( NSAIDs group ) and patients in the other group were given weekly intramuscular injections of 20 units of elcatonin ( elcatonin group ) . All patients underwent follow-up examinations up to 6 weeks from the start of the trial . Outcome measures were the level of functional impairment according to the Japan Question naire for Osteoporotic Pain ( JQ22 ) , the Rol and –Morris Disability Question naire ( RDQ ) , and a visual analog scale ( VAS ) of pain intensity . Statistical analyses focused on ( 1 ) the time course of pain and functional level using linear mixed effects models to analyze the longitudinal data and ( 2 ) the effectiveness of elcatonin injection with mean difference values and 95 % confidence intervals . Significant differences were seen over time between the initial values and the postintervention values ( 4 and 6 weeks ) in JQ22 , RDQ , and VAS scores ( effect size d > 0.4 ) in each group . The mean differences between the elcatonin group and the NSAIDs group in each measure at 4 and 6 weeks were −4.8 and −8.3 for the JQ22 , −1.3 and −2.6 for the RDQ , and −11.3 and −11.5 for the VAS , shifted to elcatonin . Once weekly elcatonin injection was more effective than NSAIDs for treating acute lumbar pain and improving mobility in Japanese women with osteoporotic vertebral fractures OBJECTIVE To evaluate three different therapeutic regimens for the prevention of osteoporosis  in natural and surgical postmenopausal women who had been found to have rapid bone loss in analytical studies . METHODS A total of 104 naturally or surgically postmenopausal women were studied , and subsequently followed-up during 1 year for avoidance of the influence of seasonal variation on bone mass , a factor overlooked in several studies . They were r and omized into four groups of 26 patients each : the  untreated control group ( mean age 50 + /- 5 years ) ; the  hormonal replacement treatment ( HRT ) group ( mean age 48 + /- 6 years ) , which was treated for 24 days each month with transdermal 17 beta-estradiol , 50 mg/day , together with medroxiprogesterone , 10 mg during 12 days ; the  calcium group ( mean age 50 + /- 4 years ) , which was treated with elemental calcium , 1 g/day ; and the  calcitonin group ( mean age 50 + /- 5 years ) , which was treated for 10 days each month with eel calcitonin , 40 IU/day and with elemental calcium , 500 mg/day . Full-body bone densitometry , for measuring total body bone mineral content ( TB BMC ) , was carried out in all the women at baseline and 1 year . TB BMC was corrected for body weight by dividing its value by body weight ( TB BMC /W ) . RESULTS After 1 year TB BMC /W was lower in every group : -2.14 % ( P < 0.001 ) in the control group ; -0.14 % ( P = NS ) in the HRT group ( P < 0.05 vs. controls ) ; -0.18 % ( P = NS ) in the calcium group ( P < 0.05 vs. controls ) ; and -0.06 % ( P = NS ) in the calcitonin group ( P < 0.01 vs. controls ; P < 0.05 vs. calcium and HRT ) . CONCLUSIONS These findings show that all three treatments are effective in the prevention of postmenopausal loss of bone mass BACKGROUND Recombinant human parathyroid hormone ( 1 - 34 ) ( rhPTH ( 1 - 34 ) ) is the first agent in a unique class of anabolic therapies acting on the skeleton . The efficacy and safety of long-term administration of rhPTH ( 1 - 34 ) in Chinese postmenopausal women had not been evaluated . This study compared the clinical efficacy and safety of rhPTH ( 1 - 34 ) with elcatonin for treating postmenopausal women with osteoporosis in 11 urban areas of China . METHODS A total of 453 postmenopausal women with osteoporosis were enrolled in an 18-month , multi-center , r and omized , controlled study . They were r and omized to receive either rhPTH ( 1 - 34 ) 20 µg ( 200 U ) daily for 18 months , or elcatonin 20 U weekly for 12 months . Lumbar spine ( L1 - 4 ) and femoral neck bone mineral density ( BMD ) , fracture rate , back pain as well as biochemical markers of bone turnover were measured . Adverse events were recorded . RESULTS rhPTH ( 1 - 34 )  increased lumbar BMD significantly more than did elcatonin after 6 , 12 , and 18 months of treatment ( 4.3 % vs. 1.9 % , 6.8 % vs. 2.7 % , 9.5 % vs. 2.9 % , P < 0.01 ) . There was only a small but significant increase of femoral neck BMD after 18 months ( 2.6 % , P < 0.01 ) in rhPTH groups . There were larger increases in bone turnover markers in the rhPTH ( 1 - 34 ) group than those in the elcatonin group after 6 , 12 , and 18 months ( serum bone-specific alkaline phosphatase ( BSAP ) 93.7 % vs. -3.6 % ; 117.8 % vs. -4.1 % ; 49.2 % vs. -5.8 % , P < 0.01 ; urinary C-telopeptide/creatinine ( CTX/Cr ) 250.0 % vs. -29.5 % ; 330.0 % vs. -41.4 % , 273.0 % vs. -10.6 % , P < 0.01 ) . rhPTH ( 1 - 34 ) showed similar effect of pain relief as elcatonin . The incidence of clinical fractures was 5.36 % ( 6/112 ) in elcatonin group and 3.2 % ( 11/341 ) in rhPTH ( 1 - 34 ) group ( P = 0.303 ) . Both treatments were well tolerated . Hypercaluria ( 9.4 % ) and hypercalcemia ( 7.0 % ) in rhPTH ( 1 - 34 ) group were transient and caused no clinical symptoms . Pruritus ( 8.2 % vs. 2.7 % , P = 0.044 ) and redness of injection site ( 4.4 % vs. 0 , P = 0.024 ) were more frequent in rhPTH ( 1 - 34 ) . Nausea/vomiting ( 16.1 % vs. 6.2 % , P = 0.001 ) and hot flushes ( 7.1 % vs. 0.6 % , P < 0.001 ) were more common in elcatonin group . CONCLUSIONS rhPTH ( 1 - 34 ) was associated with greater increases in lumbar spine BMD and bone formation markers . It could increase femoral BMD after 18 months of treatment . rhPTH could improve back pain effectively . The results of the present study indicate that rhPTH ( 1 - 34 ) is an effective , safe agent in treating Chinese postmenopausal women with osteoporosis UNLABELLED In this longitudinal , prospect i ve , and population -based study ( n = 1044 ) , seven BTMs were assessed before and after trauma in 113 elderly women ( 85 with fractures ) .  Markers were not altered in the immediate postfracture period but were clearly elevated during fracture repair . Recent fracture should thus be taken into account when markers are used in clinical practice . INTRODUCTION Fracture may influence the levels of bone turnover markers ( BTM ) and have implication s for their use in clinical practice . In this longitudinal , prospect i ve , and population -based study , we assessed prefracture levels of BTMs and compared them with postfracture levels of the same individuals immediately after fracture and during fracture repair . This is the first study in which the effect of fracture on bone markers has been evaluated with prefracture sample s available . MATERIAL S AND METHODS Serum and urine were collected at the emergency unit from 85 women ( 77.9 + /- 1.8 yr ) who sustained a fracture after low-energy trauma and 28 controls ( 77.8 + /- 2.0 yr ) with similar trauma but no fracture . All were participants of the 
    Output:
    
Elcatonin therapies and non-elcatonin medications had comparable fracture rates and bone mineral density change .
Conclusions Based on current evidence , C-E may be considered for treating postmenopausal osteoporosis because it benefits on pain relief and complications .
Moreover , it shows comparable fracture rate and bone mineral density change as compared with anti-osteoporosis and calcium supplements .