Fosamax (alendronate sodium), added to calcium and vitamin D supplementation, is a safe and effective treatment option for HIV-positive people with bone mineral loss, according to final data from a clinical trial published in the November 30 issue of AIDS.

Bone mineral loss, also known as osteopenia and osteoporosis, has been documented in 67 percent of HIV-positive people, according to one analysis of 12 different studies. In people who are HIV negative, Fosamax has been found to effectively increase bone mineral density. To determine whether or not Fosamax is also effective in people with HIV, Grace McComsey, MD, of Case Western University in Cleveland, and her colleagues enrolled 82 HIV-positive people who were on antiretroviral treatment, had stable viral loads, and had bone density loss in the lumbar spine.

After 48 weeks of treatment, people who received Fosamax plus vitamin D and calcium had a 3.38 percent increase in bone mineral density of the lumbar spine, compared with a 1.10 percent increase in those who received a placebo plus vitamin D and calcium. This comparison was statistically significant, meaning that the difference was too great to have happened by chance. Men and women responded equally well to treatment. The incidence of side effects was actually lower in the Fosamax arm compared with the placebo arm, leading the researchers to conclude that Fosamax is a safe and effective treatment for bone density problems in people with HIV.