Effects of risedronate on metabolic bone disease in patients with type 1 diabetes and osteoporosis

Pastor, M.M. Campos; Luna, Juan de Dios; Escobar-Jiménez, Fernándo; Jiménez, F.J. Gómez; Pardo, M.D. Serrano; López-Ibarra, P. J.

doi:10.1016/s1132-8460(08)72481-4

Cited by 3 publications

(3 citation statements)

References 19 publications

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“…Risedronate use associated with calcium and vitamin D ( n = 35) resulted in an increase in lumbar spine and femoral neck aBMD after 12 months in patients with osteoporosis, while no difference was observed in patients who received only calcium and vitamin D ( n = 17). [ 54 ] In light of the lack of evidence regarding osteoporosis treatment in patients with T1D, current practice is based on osteoporosis guidelines and data available from T2D. Data on T1D are urgently needed to guide treatment in this population at high risk of fractures.…”

Section: Evidence In T1dmentioning

confidence: 99%

Antiresorptive Versus Anabolic Therapy in Managing Osteoporosis in People with Type 1 and Type 2 Diabetes

Vilaca,

Eastell

2023

JBMR Plus

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Diabetes is characterized by hyperglycemia, but the two main types, type 1 diabetes (T1D) and type 2 diabetes (T2D), have distinct pathophysiology and epidemiological profiles. Individuals with T1D and T2D have an increased risk of fractures, particularly of the hip, upper arm, ankle, and nonvertebral sites. The risk of fractures is higher in T1D compared to T2D. The diagnosis of osteoporosis in individuals with T1D and T2D follows similar criteria as in the general population, but treatment thresholds may differ. Antiresorptive therapies, the first‐line treatment for osteoporosis, are effective in individuals with T2D. Observational studies and post hoc analyses of previous trials have indicated that antiresorptive drugs, such as bisphosphonates and selective estrogen receptor modulators, are equally effective in reducing fracture risk and increasing bone mineral density (BMD) in individuals with and without T2D. Denosumab has shown similar effects on vertebral fracture risk but increases the risk of nonvertebral fractures. Considering the low bone turnover observed in T1D and T2D, anabolic therapies, which promote bone formation and resorption, have emerged as a potential treatment option for bone fragility in this population. Data from observational studies and post hoc analyses of previous trials also showed similar results in increasing BMD and reducing the risk of fractures in people with or without T2D. However, no evidence suggests that anabolic therapy has greater efficacy than antiresorptive drugs. In conclusion, there is an increased risk of fractures in T1D and T2D. Reductions in BMD cannot solely explain the relationship between T1D and T2D and fractures. Bone microarchitecture and other factors play a role. Antiresorptive and anabolic therapies have shown efficacy in reducing fracture risk in individuals with T2D, but the evidence is more robust for antiresorptive drugs. Evidence in T1D is scant. Further research is needed to fully understand the underlying mechanisms and optimize management strategies for bone fragility in T1D and T2D. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

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Section: Evidence In T1dmentioning

confidence: 99%

Antiresorptive Versus Anabolic Therapy in Managing Osteoporosis in People with Type 1 and Type 2 Diabetes

Vilaca,

Eastell

2023

JBMR Plus

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“…The study by Campos et al compared the effects of risedronate and conventional osteoporosis treatment based on calcium and vitamin D supplementation in patients with type 1 diabetes mellitus. The study demonstrated an increase in bone formation markers and a significant increase in BMD at the spine and hip [ 103 ], and a group of patients with type 1 and type 2 diabetes also showed a beneficial effect of alendronate [ 104 ]. In the Fracture Intervention Trial (FIT), alendronate reduced markers of bone turnover (C-terminal telopeptide and bone-specific alkaline phosphatase levels) and improved BMD in women with T2DM) [ 105 ].…”

Section: Anti-osteoporosis Drugs and Glucose Metabolismmentioning

confidence: 99%

Treatment of Diabetes and Osteoporosis—A Reciprocal Risk?

et al. 2022

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Diabetes mellitus is a metabolic and systematic disorder that requires individualized therapy. The disease leads to various consequences, resulting in the destruction of tissues and organs. The aforementioned outcomes also include bone mineral disorders, caused by medications as well as diet therapy and physical activity. Some drugs may have a beneficial effect on both bone mineral density and the risk of fractures. Nevertheless, the impact of other medications remains unknown. Focusing on pharmacotherapy in diabetes may prevent bone mineral disorders and influence both the treatment and quality of life in patients suffering from diabetes mellitus. On the other hand, anti-osteoporosis drugs, such as antiresorptive or anabolic drugs, as well as drugs with a mixed mechanism of action, may affect carbohydrate metabolism, particularly in patients with diabetes. Therefore, the treatment of diabetes as well as osteoporosis prevention are vital for this group of patients.

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“…A few clinical studies have investigated the effects of antifracture treatment in patients with T1D. An observational study comparing the effect of risedronate and conventional treatment (calcium + vitamin D supplementation) over a 12-month period in 52 participants with T1D reported a significant increase in BMD at the spine and hip and in bone formation markers [23]. In a large Danish case-control study that included T1D and T2D patients, the fracture risk reduction at spine, hip, and forearm following alendronate therapy was similar to the risk reduction in those without diabetes [24], regardless of the type of diabetes.…”

Section: Antiresorptive Therapiesmentioning

confidence: 99%

Treatment of bone fragility in patients with diabetes: antiresorptive versus anabolic?

Shah

Appuswamy

Rao

et al. 2021

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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Purpose of review The pathogenesis of bone fragility in diabetes has not been fully characterized. The antifracture efficacy of available therapies remains unproven in patients with diabetes. We aim to collate current evidence of the treatment of diabetic bone fragility, and to provide a rationale for considering optimal therapeutic option in patients with diabetes. Recent findings The antifracture efficacy of antiresorptive and anabolic therapies is well established in patients without diabetes. Studies in patients with osteoporosis have shown that anabolic therapies lead to faster and larger benefits to bone mineral density and offer greater protection against fracture than antiresorptive therapies. Available data suggest that antiresorptive and anabolic therapies have similar effect on bone density and fracture risk reduction in patients with and without diabetes. However, the evidence in diabetes is limited to observational studies and post hoc analyses of osteoporosis studies. Summary There are no specific guidelines for the treatment of bone fragility in patients with diabetes. We offer a rationale for use of anabolic therapies in diabetes which is a low bone formation state, in contrast to postmenopausal osteoporosis that is characterized by increased bone turnover. Prospective studies evaluating the effect of available therapies on bone quality and fracture outcomes in patients with diabetes are needed.

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Effects of risedronate on metabolic bone disease in patients with type 1 diabetes and osteoporosis

Cited by 3 publications

References 19 publications

Antiresorptive Versus Anabolic Therapy in Managing Osteoporosis in People with Type 1 and Type 2 Diabetes

Antiresorptive Versus Anabolic Therapy in Managing Osteoporosis in People with Type 1 and Type 2 Diabetes

Treatment of Diabetes and Osteoporosis—A Reciprocal Risk?

Treatment of bone fragility in patients with diabetes: antiresorptive versus anabolic?

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