Reducing hip fracture risk with risedronate in elderly women with established osteoporosis

Masud,

doi:10.2147/cia.s8200

Cited by 22 publications

(19 citation statements)

References 19 publications

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“…Newer agents include strontium ranelate (capable of both inhibiting bone resorption and increasing bone formation),29,30 new-generation selective estrogen receptor modulators lasofoxifene31 and bazedoxifene,32 anabolic agents (PTH and its analogs, monoclonal antibody to sclerostin),33–36 and antiresorptive agents such as RANK signaling inhibitors (denosumab), cathepsin K inhibitors (odanacatib, balicatib, and relacatib), and antagonists of α(v)β(3) integrin (L-000845704) 34,37–39. Although the newer and emerging therapies as well as combined treatments (eg, with alfacalcidol)2 may be more potent and target-specified,2,33,37,40,41 currently, nitrogen-containing BPs, antiresorptive agents shown to reduce fracture risk by ∼50% at best,42 remain the mainstay for pharmacological treatment of osteoporosis 4,18,43–46. The antiresorptive action of BPs as a class results from both reduced osteoclastic activity (by inhibiting an enzyme farnesyl pyrophosphate synthase) and affinity for bone mineral, but the antiresorptive potency and binding affinity differ among the compounds.…”

Section: Discussionmentioning

confidence: 99%

Bisphosphonate use and hip fracture epidemiology: ecologic proof from the contrary

Fisher

Martin²,

Srikusalanukul³

et al. 2010

CIA

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Aim:The objective of this article is to evaluate the relationship between the changes in prescriptions of antiosteoporotic drugs (mainly the rapid fall in the use of bisphosphonates [BPs]) and standardized hip fracture (HF) rates over the period 2005–2008 in the Australian Capital Territory (ACT).Methods:Annual sex- and age-specific HF rates (per 100,000 population) were determined and standardized using the Australian 2006 population census. Data on the annual prescriptions of BPs (mainly alendronate and risedronate), strontium ranelate, and hormone replacement therapy were obtained from the Australian Pharmaceutical Benefits Scheme (PBS) and Repatriation Australian Pharmaceutical Benefits Scheme (RPBS) databases.Results:In the ACT, the peak annual number of prescriptions for BPs was observed in 2006. Following reports linking osteonecrosis of the jaw with BP use, the number of BP prescriptions dropped by 14% in 2007–2008 compared with 2005, when the lowest HF rates were recorded. The reduction in BP prescriptions coincided with increased HF rates in females in 2007 (+22.6%) and in 2008 (+25.2%) compared with 2005; in males, HF incidence declined by 6.6% and 16.7%, respectively. The proportion of filled prescriptions for strontium ranelate, risedronate, and alendronate in 2007–2008 was 1:8.4:15.5, indicating that BPs were the dominant antiosteoporotic drugs. There was an inverse statistically significant relationship between the total annual number of BP prescriptions and standardized HF incidence rates for the 10-year period 1999–2008.Conclusion:Although currently there is no clear understanding of factors contributing to changing HF epidemiology, the available evidence suggests that much of the decline in HF rates is due to the use of BPs. The fall in the use of BPs is associated with an increase in HF rates in females, indicating that BPs should still be considered the first-line medications for the prevention and treatment of osteoporosis. Our results need to be confirmed in other populations and countries.

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Section: Discussionmentioning

confidence: 99%

Bisphosphonate use and hip fracture epidemiology: ecologic proof from the contrary

Fisher

Martin²,

Srikusalanukul³

et al. 2010

CIA

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“…A post hoc analysis of the HIP and VERT studies showed that, compared with placebo, risedronate reduced the risk of hip fracture by 46% (RR ¼ 0.54, CI: 0.320.91) in women aged 70100 years with established osteoporosis [Masud et al 2009]. …”

Section: Therapeutic Advances In Chronic Disease 2 (4)mentioning

confidence: 99%

Pharmacological treatments for osteoporosis in very elderly people

Chua

Nandi

Masud

2011

Therapeutic Advances in Chronic Disease

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Only a few randomized controlled trials investigating antiosteoporotic agents with fracture endpoints have included participants over the age of 80 years. The pivotal trial with alendronic acid had an upper age range of 80 years, although a separate trial that showed a significant reduction in nonvertebral fractures included some participants up to age of 84 years. Risedronate and zoledronic acid are the only bisphosphonates to show a significant reduction in new vertebral, hip and nonvertebral fractures during a 3-year period in those over 80 years of age. In addition, zoledronic acid was associated with a reduction in the rate of new clinical fractures and improved survival in elderly subjects after hip fracture. More recently, denosumab was found to significantly reduce the risk of new radiographic vertebral, hip and nonvertebral fractures in women up to the age of 89 years with osteoporosis. Strontium ranelate and teriparatide have shown fracture reductions in populations that have included subjects over the age of 80 years. There has been evidence to show that a combination of calcium and vitamin D reduces nonvertebral fracture in older populations. The role of vitamin D alone is less clear, although there is the suggestion that it may be effective at higher doses. The burden of osteoporosis is unquestionably rising within our ageing population. More emphasis is therefore required on researching the benefits of these pharmacological agents in very elderly people.

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“…A post-hoc analysis of the HIP trial combined the 70–79 and ≥80 year old groups but included only those patients who had confirmed osteoporosis, as defined by a baseline femoral neck T-score ≤−2.5 and 1 or more prior vertebral fracture(s) 19. Using these criteria, 1656 women (1090 who received risedronate and 566 who received placebo) from the intent to treat population were included in the analysis.…”

Section: Clinical Studiesmentioning

confidence: 99%

Risedronate's Role in Reducing Hip Fracture in Postmenopausal Women with Established Osteoporosis

Gates

Das

2012

Clin Med�Insights�Arthritis�Musculoskelet Disord

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Osteoporosis is a significant concern for postmenopausal women and is a critical factor in hip fracture. Examining evidence for osteoporosis medications in hip fracture is important for optimizing treatment.PurposeReview risedronate’s role for hip fracture in postmenopausal women.MethodsA literature search was conducted using Medline and Web of Science. The search was limited using the terms “risedronate” and “hip fracture,” and to studies that included women. Similar articles linked to the search and pertinent articles in bibliographies were also examined.ResultsRisedronate has demonstrated efficacy and cost effectiveness for hip fracture, but may not be beneficial for patients with low fracture risk. Risedronate is generally well tolerated, but may cause side effects in some patient populations.ConclusionRisedronate has benefit for hip fracture, but patients should be carefully screened to determine the appropriateness of risedronate before starting treatment.

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Reducing hip fracture risk with risedronate in elderly women with established osteoporosis

Cited by 22 publications

References 19 publications

Bisphosphonate use and hip fracture epidemiology: ecologic proof from the contrary

Bisphosphonate use and hip fracture epidemiology: ecologic proof from the contrary

Pharmacological treatments for osteoporosis in very elderly people

Risedronate's Role in Reducing Hip Fracture in Postmenopausal Women with Established Osteoporosis

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