***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 : The purpose of this r and omized , double-masked , placebo-controlled study was to determine the efficacy and safety of risedronate in the prevention of vertebral fractures in postmenopausal women with established osteoporosis . The study was conducted at 80 study centers in Europe and Australia . Postmenopausal women ( n= 1226 ) with two or more prevalent vertebral fractures received risedronate 2.5 or 5 mg/day or placebo ; all subjects also received elemental calcium 1000 mg/day , and up to 500 IU/day vitamin D if baseline levels were low . The study duration was 3 years ; however , the 2.5 mg group was discontinued by protocol amendment after 2 years . Lateral spinal radiographs were taken annually for assessment of vertebral fractures , and bone mineral density was measured by dual-energy X-ray absorptiometry at 6-month intervals . Risedronate 5 mg reduced the risk of new vertebral fractures by 49 % over 3 years compared with control ( p<0.001 ) . A significant reduction of 61 % was seen within the first year ( p= 0.001 ) . The fracture reduction with risedronate 2.5 mg was similar to that in the 5 mg group over 2 years . The risk of nonvertebral fractures was reduced by 33 % compared with control over 3 years ( p= 0.06 ) . Risedronate significantly increased bone mineral density at the spine and hip within 6 months . The adverse-event profile of risedronate , including gastrointestinal adverse events , was similar to that of control . Risedronate 5 mg provides effective and well-tolerated therapy for severe postmenopausal osteoporosis , reducing the incidence of vertebral fractures and improving bone density in women with established disease 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 BACKGROUND : Osteoporosis has become a major health problem worldwide , and the incidence is rising in Asian countries . The aminobisphosphonates are potent inhibitors of bone resorption and are currently the mainstay of treatment for postmenopausal osteoporosis . Dosing frequency will likely affect tolerability and adherence to treatment . OBJECTIVE : To assess the tolerability and efficacy of a once-weekly aminobisphosphonate preparation in improving bone mineral density ( BMD ) and bone turnover markers in osteoporotic Asian women . METHODS : Chinese postmenopausal women with osteoporosis were r and omized to receive either alendronate 70 mg once weekly plus calcium carbonate 500 mg daily ( n = 29 % ) or calcium carbonate 500 mg daily ( n = 29 % ) for one year . BMD was measured by dual energy X-ray absorptiometry . Markers of bone formation and bone resorption included plasma total alkaline phosphatase and urine N-telopeptides . RESULTS : Treatment with alendronate 70 mg once weekly for one year result ed in significant BMD improvement of 6.1 % at the spine , 5.6 % at the femoral neck , and 3.5 % at the total hip . There was no significant change in the BMD values in the calcium group ( spine 1.4 % , femoral neck −0.2 % , total hip 0 % ) . The BMD response in the alendronate group was significantly different from that in the calcium group at all time points , and the difference was detectable as early as after 3 months of treatment ( ANOVA p < 0.001 % ) . The changes remained significant after adjusting for age , age at menarche , and years since menopause ( p < 0.001 % ) . Similarly , the reductions in bone markers at 12 months were significantly different between the 2 treatment groups ( plasma total alkaline phosphatase : alendronate 27.9 % , calcium 5.4 % ; urine N-telopeptide : alendronate 55.6 % , calcium 11.2 % ; both p < 0.001 % ) . The alendronate regimen was well tolerated , without significant adverse events . CONCLUSIONS : The results confirmed that once-weekly alendronate was efficacious in increasing BMD and reducing bone turnover and was well tolerated in Asian women The identification of risk factors for osteoporosis has been an essential step towards the underst and ing of the onset of the disease as well as of the osteoporosis-related fractures due to bone fragility . The present study has been aim ed at assessing whether a correlation may exist between the increment in bone mass , consequent to an antiresorption therapy , and the reduction in the incidence of fractures . Moreover , the possibility that such a reduction might result from the action of other factors , such as the changes in bone microstructure , has been investigated . A total of 2,000 osteoporotic women ( mean age : 68 + /- 9 years ) were enrolled in the study and divided at r and om into 4 treatment groups . Each group received one of the following treatments : Alendronate 10 mg/daily ( 1,000 patients ) , Clodronate 100 mg/weekly i.m . ( 800 patients ) , Risedronate 5 mg/dailt ( 100 patients ) , and Raloxifene 60 mg/daily ( 100 patients ) . Clinical evaluation was based on bone mineral density ( BMD ) assay on lumbar vertebrae ( L1-L4 ) by means of a DEXA ( Lunar DPX ) mineralometer , as well as on the incidence of fractures following both 12- and 24-month treatment periods . The results showed an overlapping pattern in patients treated with Alendronate or Risedronate , namely a significant increment in BMD after a 24-month treatment period , whereas such an increment in BMD was less evident in patients receiving either Clodronate or Risedronate after a 24-month treatment period . In addition , a total of 18 osteoporosis-related fractures were observed during the entire study period ; 10 out of 18 fractures occurred in the Alendronate treated group , whereas the remaining 8 fractures were observed in the Clodronate treated group . Fourteen fractures were detected in patients over 80-year old , whereas the remaining 4 occurred in patients aged from 70 to 79 years and appeared to be independent of both the T-score assigned and the BMD increment obtained as a result of the therapy . Such findings suggest that the plain monitoring of BMD appears not to be adequate to anticipate clearly the danger of the probable onset of additional fractures , while the higher incidence of fractures in patients over 80-year old evidence s that " old age " has to be considered the most serious risk factor for osteoporosis , since it is also the real responsible factor for changes taking place in bone microstructure BACKGROUND Despite its association with disability , death , and increased medical costs , osteoporosis in men has been relatively neglected as a subject of study . There have been no large , controlled trials of treatment in men . METHODS In a two-year double-blind trial , we studied the effect of 10 mg of alendronate or placebo , given daily , on bone mineral density in 241 men ( age , 31 to 87 years ; mean , 63 ) with osteoporosis . Approximately one third had low serum free testosterone concentrations at base line ; the rest had normal concentrations . Men with other secondary causes of osteoporosis were excluded . All the men received calcium and vitamin D supplements . The main outcome measures were the percent changes in lumbar-spine , hip , and total-body bone mineral density . RESULTS The men who received alendronate had a mean ( + /-SE ) increase in bone mineral density of 7.1+/-0.3 percent at the lumbar spine , 2.5+/-0.4 percent at the femoral neck , and 2.0+/-0.2 percent for the total body ( P<0.001 for all comparisons with base line ) . In contrast , men who received placebo had an increase in lumbar-spine bone mineral density of 1.8+/-0.5 percent ( P<0.001 for the comparison with base line ) and no significant changes in femoral-neck or total-body bone mineral density . The increase in bone mineral density in the alendronate group was greater than that in the placebo group at all measurement sites ( P<0.001 ) . The incidence of vertebral fractures was lower in the alendronate group than in the placebo group ( 0.8 percent vs. 7.1 percent , P=0.02 ) . Men in the placebo group had a 2.4-mm decrease in height , as compared with a decrease of 0.6 mm in the alendronate group ( P=0.02 ) . Alendronate was generally well tolerated . CONCLUSIONS In men with osteoporosis , alendronate significantly increases spine , hip , and total-body bone mineral density and helps prevent vertebral fractures and decreases in height This study was undertaken to compare the effects of alendronate and risedronate on bone mineral density ( BMD ) and bone turnover markers ( BTMs ) in late postmenopausal women with osteoporosis . Thirty women older than 60 y of age were r and omly assigned to receive alendronate 10 mg ( n=16 ) or risedronate 5 mg ( n=14 ) on a daily basis . The patients were followed every 3 mo for 12 mo . BMD measurements were taken at baseline and at the end of the study , and BTMs were measured at 3-mo intervals . By the end of the study , there were statistically significant increases in BMD in both groups at all sites at which they were measured ( P < .001 ) . However , these differences were not statistically significant between groups . By the end of the study , all BTMs had decreased 
    Output:
    
All treatments examined were associated with beneficial effects on fractures and femoral neck BMD relative to placebo .
For vertebral fractures and percentage change in femoral neck BMD the treatment effects were statistically significant for all treatments .
Pairwise comparisons between treatments indicated that no active treatment was statistically significantly more effective than any other active treatment for fracture outcomes .
There was some heterogeneity in treatment effects between studies suggesting differential treatment effects according to study characteristics ; however , there was no evidence of differential treatment effects with respect to gender and age