Hip fracture risk and safety with alendronate treatment in the oldest‐old

Axelsson, Kristian F; Wallander, Michelle L.; Johansson, Helena; Lundh, Dan; Lorentzon, Mattias

doi:10.1111/joim.12678

Cited by 52 publications

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References 31 publications

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“…In this issue, Axelsson et al [7] address the topic of alendronate efficacy and safety in the oldest old using a unique observational data set with very detailed information on not only comorbidity but also BMI, physical function and falls to examine whether the results from the RCTs of alendronate in terms of safety and efficacy remain robust in a real-world setting of secondary fracture prevention in this age group. As is clear to all who have experienced the difficulty of recruiting to a clinical trial, the number of patients approached for inclusion in RCTs greatly exceeds those eventually included because of extensive exclusion criteria.…”

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confidence: 99%

“…In the study by Axelsson et al [7], a large national database covering more than 400 000 elderly Swedes with a full fall risk assessment was used to extract a subcohort consisting of the patients who were aged 80 years and above and who had experienced a fracture within the last few years. As use of alendronate was the result of a decision by patients and their physicians, inclusion in this group is not random so characteristics at the time of the baseline falls assessment were not identical between alendronate users and nonusers.…”

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confidence: 99%

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The emperor redressed: treating osteoporosis to prevent hip fractures in the oldest old

Abrahamsen

2017

J Intern Med

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confidence: 99%

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confidence: 99%

The emperor redressed: treating osteoporosis to prevent hip fractures in the oldest old

Abrahamsen

2017

J Intern Med

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“…Unfortunately, this treatment was also associated with a 58% increase in the risk of mild upper gastrointestinal (GI) symptoms. 37 The GI side effects are the most typical AEs associated with oral BPs and may involve a large number of users (about 25%). 6 However, of this 25%, less than 1% require hospitalization due to GI bleeding.…”

Section: Hormonal Therapymentioning

confidence: 99%

Pharmacological Management of Osteoporosis in Postmenopausal Women: The Current State of the Art

Gatti

Fassio

2019

jptcp

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Osteoporosis is a common disease that increases fracture risk. Fragility fractures bring heavy consequences in terms of mortality and disability, with burdensome health and social costs. In subjects with clinical bone fragility, the first goal is to identify the secondary forms of osteoporosis, especially in young subjects, in males and in patients who recently experienced a fragility fracture. In addition, before considering any sort of treatment, it is fundamental to check for adequate calcium and vitamin D intake, since their deficiency is the most common reason for drug failure. In the last decade of the 20th century, several molecules have been developed and proved to be effective in achieving the true goal of any antiosteoporotic drug: fracture prevention. In this article, we considered the most commonly prescribed antiresorptive drugs (hormonal therapy, bisphosphonates, and denosumab), the anabolic agents (teriparatide), the dual-action drugs (romosozumab), and the drugs characterized by an unclear mechanism of action (strontium ranelate) to provide physicians with useful insights for their clinical practice. We discussed the main criteria for the appropriate choice selection and management of each treatment. Finally, we addressed the current controversies related to treatment discontinuation, sequential, and combination therapy.

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“…These medications have a powerful antiresorptive effect targeted directly at osteoclasts, resulting in marked decrease of bone resorption, however our old patients suffering from senile osteoporosis do not have increased markers of osteoresorption. Data from Axelsson et al (2017) show that in old patients with prior fracture alendronate reduce the risk of hip fracture. The study has limitation there is lack of data regarding bone densitometry and fracture trauma type.…”

Section: )mentioning

confidence: 99%

Sarcoporosis Is a Part of Aging

Broulík

2019

Prague Med. Rep.

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Ageing is associated with the accumulation of damage to all the macromolecules within and outside cells leading to progressively more cellular and tissue defects and resulting in age-related frailty, disability and disease. As a result of the aging process the bone deteriorates in composition, structure and function. Age-related musculoskeletal losses are a major public health burden because they can cause physical disability and increased mortality. We tried to find out on a small set of old women, without risk factors for osteoporosis, what caused them the loss of bone minerals. All 492 women had just only one risk factor – the old age. Laboratory findings have shown a decreased serum C telopeptide and low serum alkaline phosphatase circulating markers, used to quantify bone resorption and formation, and very low level of vitamin D. Very low level of vitamin D that disrupted calcium absorption through the intestine, and decreased calcemia increased parathyroid hormone levels with resulting bone effect. The manifestation of physiological aging is worsening eyesight, peripheral neuropathy, depression, worsening of physical condition, skin aging, sarcopenia and bone mineral loss. Senile osteoporosis, which is not caused by known risk factors for osteoporosis, does not appear to be a separate disease, but is part of the physiological process of aging. Treatment of senile osteoporosis should be focused on the control of secondary hyperparathyroidism by administration of vitamin D and calcium. The risk of fractures in the advanced age is determined by a large number of factors ranging from hazards in the home environment to frailty and poor balance.

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Hip fracture risk and safety with alendronate treatment in the oldest‐old

Cited by 52 publications

References 31 publications

The emperor redressed: treating osteoporosis to prevent hip fractures in the oldest old

The emperor redressed: treating osteoporosis to prevent hip fractures in the oldest old

Pharmacological Management of Osteoporosis in Postmenopausal Women: The Current State of the Art

Sarcoporosis Is a Part of Aging

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