Risedronate and ergocalciferol prevent hip fracture in elderly men with Parkinson disease.
BACKGROUND
There is a high incidence of hip fractures in patients with Parkinson disease (PD). Bone mineral density (BMD) is decreased in patients with PD, correlating with the immobilization-induced bone resorption and hypovitaminosis D with compensatory hyperparathyroidism.


OBJECTIVE
To evaluate the effectiveness of risedronate, an inhibitor of bone resorption, on osteoporosis and the risk of hip fractures in elderly men with PD.


METHODS
This was a 2-year, randomized, double-blind, placebo-controlled trial. In a prospective study of patients with PD, 121 patients received a daily dose of 2.5 mg risedronate and vitamin D2 1,000 IU for 2 years, and the remaining 121 received placebo and vitamin D2 1,000 IU. Incidence of hip fractures was compared between the two groups.


RESULTS
Nine patients sustained hip fractures in the placebo group, and three hip fractures occurred in the risedronate group. The relative risk of a hip fracture in the risedronate group vs the placebo group was 0.33 (95% CI, 0.09 to 1.20). BMD increased by 2.2% in the risedronate group and decreased by 2.9% in the placebo group (p < 0.0001). Urinary deoxypyridinoline, a bone resorption marker, decreased by 46.7% in the risedronate group and by 33.0% in the placebo group.


CONCLUSIONS
Treatment with risedronate and vitamin D2 increases bone mineral density in elderly men with Parkinson disease and reduces the risk of hip fractures.
Sato
Yoshihiro
Y
Department of Neurology, Mitate Hospital, 3237 Yugeta, Tagawa 826-0041, Japan. y-sato@ktarn.or.jp
Honda
Yoshiaki
Y
Iwamoto
Jun
J
D000368:Aged; D000369:Aged, 80 and over; D000596:Amino Acids / Q000652:urine; D015415:Biomarkers / Q000652:urine; D015519:Bone Density / Q000187:drug effects / Q000502:physiology; D050071:Bone Density Conservation Agents / Q000008:administration & dosage; D001862:Bone Resorption / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D004311:Double-Blind Method; D004872:Ergocalciferols / Q000008:administration & dosage*; D012968:Etidronic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006620:Hip Fractures / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D006961:Hyperparathyroidism / Q000150:complications / Q000503:physiopathology; D008297:Male; D010024:Osteoporosis / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D010300:Parkinson Disease / Q000150:complications* / Q000503:physiopathology; D015990:Placebo Effect; D011446:Prospective Studies; D000068296:Risedronic Acid; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D014808:Vitamin D Deficiency / Q000150:complications / Q000503:physiopathology
D000596:Amino Acids; D015415:Biomarkers; D050071:Bone Density Conservation Agents; D004872:Ergocalciferols; C036020:deoxypyridinoline; D000068296:Risedronic Acid; D012968:Etidronic Acid