title: Effect of risedronate on the risk of hip fracture in elderly women. Hip Intervention Program Study Group.
abstract: BACKGROUND
  Risedronate increases bone mineral density in elderly women, but whether it prevents hip fracture is not known.
  
  
  METHODS
  We studied 5445 women 70 to 79 years old who had osteoporosis (indicated by a T score for bone mineral density at the femoral neck that was more than 4 SD below the mean peak value in young adults [-4] or lower than -3 plus a nonskeletal risk factor for hip fracture, such as poor gait or a propensity to fall) and 3886 women at least 80 years old who had at least one nonskeletal risk factor for hip fracture or low bone mineral density at the femoral neck (T score, lower than -4 or lower than -3 plus a hip-axis length of 11.1 cm or greater). The women were randomly assigned to receive treatment with oral risedronate (2.5 or 5.0 mg daily) or placebo for three years. The primary end point was the occurrence of hip fracture.
  
  
  RESULTS
  Overall, the incidence of hip fracture among all the women assigned to risedronate was 2.8 percent, as compared with 3.9 percent among those assigned to placebo (relative risk, 0.7; 95 percent confidence interval, 0.6 to 0.9; P=0.02). In the group of women with osteoporosis (those 70 to 79 years old), the incidence of hip fracture among those assigned to risedronate was 1.9 percent, as compared with 3.2 percent among those assigned to placebo (relative risk, 0.6; 95 percent confidence interval, 0.4 to 0.9; P=0.009). In the group of women selected primarily on the basis of nonskeletal risk factors (those at least 80 years of age), the incidence of hip fracture was 4.2 percent among those assigned to risedronate and 5.1 percent among those assigned to placebo (P=0.35).
  
  
  CONCLUSIONS
  Risedronate significantly reduces the risk of hip fracture among elderly women with confirmed osteoporosis but not among elderly women selected primarily on the basis of risk factors other than low bone mineral density.
authors.affiliation: Oregon Osteoporosis Center and Providence Medical Center, Portland 97213, USA. mmcclung@oregonosteoporosis.com
authors.forename: M R
authors.initials: MR
authors.lastname: McClung
authors.forename: P
authors.initials: P
authors.lastname: Geusens
authors.forename: P D
authors.initials: PD
authors.lastname: Miller
authors.forename: H
authors.initials: H
authors.lastname: Zippel
authors.forename: W G
authors.initials: WG
authors.lastname: Bensen
authors.forename: C
authors.initials: C
authors.lastname: Roux
authors.forename: S
authors.initials: S
authors.lastname: Adami
authors.forename: I
authors.initials: I
authors.lastname: Fogelman
authors.forename: T
authors.initials: T
authors.lastname: Diamond
authors.forename: R
authors.initials: R
authors.lastname: Eastell
authors.forename: P J
authors.initials: PJ
authors.lastname: Meunier
authors.forename: J Y
authors.initials: JY
authors.lastname: Reginster
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000187:drug effects; D002121:Calcium Channel Blockers / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D012968:Etidronic Acid / Q000009:adverse effects / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D006620:Hip Fractures / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000188:drug therapy*; D000068296:Risedronic Acid; D012307:Risk Factors
chemical_list: D002121:Calcium Channel Blockers; D000068296:Risedronic Acid; D012968:Etidronic Acid