Beneficial effect of risedronate for preventing recurrent hip fracture in the elderly Japanese women

Abstract

SummaryA 36-month observational study compared the incidence of unaffected side hip fracture in Japanese female osteoporosis patients with a history of hip fracture between 173 patients receiving risedronate and 356 risedronate-untreated controls. New hip fractures were significantly less frequent in the risedronate group, suggesting a preventive effect in high-risk patients.IntroductionThe purpose of this study was to investigate the preventive effect of risedronate on second hip fracture immediately following a first hip fracture in Japanese female osteoporosis patients with unilateral hip fracture.MethodsWe conducted a prospective matched cohort study in 184 patients treated with risedronate and 445 patients not receiving risedronate after discharge from hospital. Both groups were followed-up for 36 months, and the incidence of unaffected side hip fracture and the frequency of adverse events were assessed.ResultsEfficacy could be investigated in 173 patients from the risedronate group and 356 patients from the control group. Hip fracture was detected in 5 and 32 patients, respectively. Kaplan–Meier estimates of the 36-month fracture incidence were 4.3% in the risedronate group and 13.1% in the control group (P = 0.010, log-rank test). The hazard ratios (95% confidence intervals) obtained by univariate and multivariate analysis were 0.310 (0.121–0.796) and 0.218 (0.074–0.639), respectively, indicating a significantly lower incidence of unaffected side hip fracture in the risedronate group. Adverse events occurred in 38 patients (48 events) from the risedronate group and 94 patients (108 events) from the control group, with serious adverse events in 21 patients (26 events) and 78 patients (88 events), respectively.ConclusionsNo significant differences were observed between the two groups. The incidence of unaffected side hip fracture was significantly lower in the risedronate group. Accordingly, risedronate may have a preventive effect on hip fracture in high-risk Japanese female osteoporosis patients for fracture with a history of unilateral hip fracture.

Clinical Efficacy on Fracture Risk and Safety of 0.5 mg or 1 mg/month Intravenous Ibandronate Versus 2.5 mg/day Oral Risedronate in Patients with Primary Osteoporosis

“…The VERT studies previously highlighted the nonvertebral fracture efficacy of risedronate in a white population [12, 13]. Additionally, a 3-year study in Japanese patients with osteoporosis who had previously undergone surgery for hip fracture, reported that risedronate 2.5 mg significantly reduced the incidence of contralateral hip fracture [20]. In the present study, the risk ratio of nonvertebral fracture between the 1 mg [annual cumulative exposure (ACE) 12 mg] and 0.5 mg (ACE 6 mg) ibandronate groups was 0.80 (95 % CI 0.47–1.36), which is within the range described in a pooled analysis of different ibandronate doses [31].…”

“…Based on these results, the optimal oral dose of risedronate in Japanese osteoporotic patients was determined and licensed as 2.5 mg daily or 17.5 mg weekly [18]. Reduction in fracture risk has been observed for vertebral [19] and hip [20] fractures at this dose. Although placebo-controlled data for fracture risk have not been obtained in Japanese patients, risedronate 2.5 mg daily is a suitable active comparator to assess fracture prevention efficacy in Japanese osteoporotic patients.…”

Randomized controlled trial of zoledronic acid for treatment of osteoporosis in women

“…[12][13] Alendronate and risedronate have been reported to reduce nonvertebral and hip fractures in women with osteoporosis. [14][15][16][17][18] Zoledronic acid (ZOL) is an aminobisphosphonate that has a prolonged dosing interval and a high affinity for mineralized bone. 19 Intravenous infusion of ZOL may rapidly localize to bone, where it reduces osteoclastic bone resorption through inhibition of farnesyl pyrophosphate synthase, which is a key enzyme in the mevalonate pathway.…”

Características y evolución de las fracturas de cadera operadas en el Banco de Prótesis (enero-diciembre 2013)

“…Pese a la disponibilidad en Uruguay de fármacos seguros y eficaces para la prevención de fracturas, la mayoría de los pacientes con fractura de cadera no reciben tratamiento adecuado para la OP (6)(7)(8) . Importantes estudios (9,10) han demostrardo el beneficio que ofrece el tratamiento médico en cuanto a la disminución del riesgo de muerte y de nuevas fracturas clínicas. El tratamiento quirúrgico de las fracturas de fémur proximal se realiza mediante artroplastia (sustitución total o parcial de la articulación mediante un implante protésico) u osteosíntesis (reducción y fijación de la fractura mediante implante de distintos dispositivos).…”