Risedronate therapy for prevention of hip fracture after stroke in elderly women.
BACKGROUND
There is a high incidence of hip fractures in patients with hemiplegic stroke. Bone mineral density (BMD) is decreased in the hemiplegic side in patients after stroke, correlating with the degree of paralysis and of hypovitaminosis D.


OBJECTIVE
To evaluate the efficacy of risedronate in reducing the severity of osteoporosis and in decreasing the risk of hip fractures in elderly women following an acute stroke.


METHODS
This was a 12-month, randomized, double blind, placebo-controlled trial. In a prospective study of stroke patients, 187 patients received a daily dose of 2.5 mg risedronate for 12 months, and the remaining 187 received placebo. Incidence of hip fracture was compared between the two groups at the endpoint of the study.


RESULTS
Seven patients sustained hip fractures on the hemiplegic side in the placebo group, and one hip fracture occurred in the risedronate group (p = 0.0360; OR = 7.0). BMD increased by 1.5% and decreased by 4.9% in the risedronate group and placebo group (p < 0.0001). Urinary deoxypyridinoline, a bone resorption marker, decreased by 53.4% in the risedronate group and increased by 35.8% in the placebo group.


CONCLUSIONS
Treatment with risedronate increases bone mineral density in elderly women following an acute stroke and prevents hip fractures.
Sato
Yoshihiro
Y
Department of Neurology, Mitate Hospital, 3237 Yugeta, Tagawa 826-0041, Japan. y-sato@ktarn.or.jp
Iwamoto
Jun
J
Kanoko
Tomohiro
T
Satoh
Kei
K
D000058:Accidental Falls / Q000706:statistics & numerical data; D000368:Aged; D015519:Bone Density / Q000187:drug effects / Q000502:physiology; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D002118:Calcium / Q000097:blood; D004311:Double-Blind Method; D012968:Etidronic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006429:Hemiplegia / Q000150:complications*; D006620:Hip Fractures / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D010024:Osteoporosis / Q000517:prevention & control*; D010919:Placebos; D000068296:Risedronic Acid; D020521:Stroke / Q000150:complications*; D013995:Time; D016896:Treatment Outcome
D050071:Bone Density Conservation Agents; D010919:Placebos; D000068296:Risedronic Acid; D012968:Etidronic Acid; D002118:Calcium