Secondary endpoints included length of the period to the occurrence of new vertebral fractures, the risk of patients and length of the period to the occurrence of clinical fractures, changes in height, and relative changes in bone turnover markers. Assessment of vertebral fractures Lateral radiographs of the thoracic and lumbar spine were taken at the screening visit to determine the presence of prevalent fractures. Subjects were enrolled based
on a visual assessment of prevalent fractures in T4 to L4. All the radiologic specifications and the levels of vertebra at the thoracic sand lumbar spine were standardized throughout learn more the study sites. The assessment of prevalent fractures was made if the ratio of anterior or middle vertebral body height to the posterior vertebral body height was less than 0.8 [11]. Quantitative and semiquantitative techniques [12, 13] were used to identify incident vertebral fractures for the purposes of the efficacy determination. Lateral radiographs of the spine were performed at 6, 12, 18, and 24 months for the assessment of incident fractures. An incident of new vertebral fracture was diagnosed if the anterior, posterior, or middle vertebral height had decreased by at least 15% and by 4 mm in a vertebra that was normal at baseline, or semiquantitatively
as a progress in grades [11]. Morphological diagnosis of fractures was made by quantitative and semiquantitative assessment of two evaluators who were blinded CYC202 cell line to the sequence Paclitaxel of films at two independent central reading facilities at Tottori University, Yonago, Japan by Hagino, H. and at the University of Occupational and Environmental Health, Fukuoka, Japan by Nakamura, T., with adjudication by a third investigator (Nakano,T. at Tamana Central Hospital, Kumamoto, Japan) in the event of discrepant results. Assessment of non-vertebral fractures All non-vertebral fractures were identified symptomatically as clinical fractures, and only non-traumatic fractures assessed by investigators were reported. Suspected clinical fractures at six non-vertebral sites (humerus, radius/ulna,
subclavia, pelvis, femur, and tibia/fibula) were adjudicated radiographically, and only radiographically confirmed fractures were listed. Assessment of bone turnover Serum and urine samples were collected at baseline, 6, 12, 18, and 24 months for measurement of bone turnover markers, including urinary total deoxypyridinoline (DPD) measured by high-performance liquid chromatography (SRL, Tokyo, Japan) [14] after acid hydrolysis, urinary type I collagen Compound C cost N-telopeptide (NTX; Osteomark, Ostex International, Seattle, WA, USA), serum bone-specific alkaline phosphatase (BALP; Osteolinks “BAP”, Quidel, San Diego, CA, USA), serum osteocalcin (BGP-IRMA Mitsubishi; Mitsubishi Kagaku Iatron, Tokyo, Japan), and serum 25-hydroxyvitamin D (25(OH)D; 125I RIA Kit, DiaSorin Inc., Saluggia, Italy).