Risedronate, a novel pyridinyl bisphosphonate for the treatment of osteoporosis and Paget's disease of bone.
Osteoporosis and Paget's disease of bone are the most common metabolic bone diseases. They cause considerable disability and pain, and reduce quality of life. The elderly are at greatest risk of osteoporotic fractures, and in an ageing world population, the burden of the disease is likely to increase. Bisphosphonates are known to be effective antiresorptive agents for the treatment of Paget's disease of bone, postmenopausal osteoporosis (PMO) and corticosteroid-induced osteoporosis (CIO). However, some bisphosphonates have been associated with troublesome gastrointestinal side-effects. Risedronate is a novel pyridinyl bisphosphonate recently approved in the USA for the treatment of Paget's disease, and is under development for the treatment of PMO and CIO. Risedronate is effective and well-tolerated in the treatment of Paget's disease. It has the shortest treatment regimen of any oral bisphosphonate; a two month course of therapy results in sustained remission, as determined by biochemical indices. The results of recent clinical trials suggest that risedronate is also an effective, well-tolerated therapy for PMO and CIO. Risedronate represents an advance in the therapeutic options available for the treatment of Paget's disease, and is expected to be of further value for treatment of PMO and CIO when it receives approval for use in these conditions.
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The Cleveland Clinic Foundation, 9500 Euclid Avenue, Ohio 44195, USA. licataa@cesmtp.ccf.org