[Bisphosphonate treatment prevents hip fractures in 70-79 year old women with osteoporotic vertebral fractures].
According to the data of a fracture intervention trial, in women aged 55-80 years with vertebral fractures or osteoporosis diagnosed by bone mineral density measurement, treatment with the bisphosphonate alendronate prevented hip fractures with numbers-needed-to-treat within 5 years of treatment of 46 and 66, respectively. In a large risedronate hip fracture study, this new bisphosphonate only showed a beneficial effect in women aged 70-79 years with moderately severe osteoporosis as judged by femoral neck T-score, when one or more vertebral fractures were present at the start of the treatment. The number-needed-to-treat was 29. However, in women aged over 80 years and who were selected predominantly on the basis of clinical risk factors for hip fracture, no effect was found with this drug on hip fracture rate, suggesting that most were not osteoporotic and/or that the clinical risk factors used did not have the clinical utility in identifying hip fracture risk. Other factors besides osteoporosis may play a more important role in causing hip fracture in this elderly group. Diagnosis of osteoporotic vertebral fractures in women aged 70-79 years is predictive of not only new vertebral fractures but also of hip fractures, and could therefore form an indication for drug treatment.
Netelenbos
J C
JC
Academisch Ziekenhuis Vrije Universiteit, afd. Endocrinologie, Postbus 7057, 1007 MB Amsterdam. c.netelen@azvu.nl
D000367:Age Factors; D000368:Aged; D019386:Alendronate / Q000627:therapeutic use*; D015519:Bone Density / Q000187:drug effects; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D004164:Diphosphonates / Q000627:therapeutic use*; D012968:Etidronic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use*; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries; D015337:Multicenter Studies as Topic; D009426:Netherlands / Q000453:epidemiology; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000188:drug therapy*; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D000068296:Risedronic Acid; D016103:Spinal Fractures / Q000175:diagnosis / Q000209:etiology*
D002121:Calcium Channel Blockers; D004164:Diphosphonates; D000068296:Risedronic Acid; D012968:Etidronic Acid; D019386:Alendronate