BoneKEy Reports | BoneKEy Watch
Bisphosphonates reduce fracture risk in women on glucocorticoids
DOI:10.1038/bonekey.2012.178
A large observational study of over 11 000 women who had received glucocorticoid (GC) treatment, defined as 450 mg prednisolone equivalent pills within 90 days of the start of the study, examined how long-term bisphosphonate (BP) therapy affected fracture incidence. A total of 6359 women received alendronate and 4648 received risedronate.
The rates of vertebral and non-vertebral fractures were recorded for the first three months of BP therapy, and compared with the rates in the subsequent 12 months of BP use. Fracture rates in both groups during the first three-month period were similar, and a subsequent significant reduction in fracture rate was noted in both groups (P<0.05).
Although the study was limited in that it could not compare the efficacy of the two BPs directly, the authors highlight that the decrease in both fracture types in both groups was within the same confidence intervals, suggesting they may be equally beneficial.
Editor's comment: BPs are prescribed for patients receiving GC therapy who are osteopenic or worse, but evidence of their efficacy in this setting is largely based on randomized controlled trials that used a change in bone mineral density as a surrogate endpoint. This observational study of GC patients receiving alendronate or risedronate now provides more substantial evidence that these BPs significantly reduce fracture incidence when taken in the long term.
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