Bisphosphonates in the treatment of osteoporosis.
Evidence from randomized, double-blind, placebo-controlled trials demonstrates the safety and effectiveness of alendronate in the prevention of vertebral fractures in postmenopausal women with low bone density and in the prevention of vertebral as well as hip and wrist fractures in postmenopausal women with low bone density and prevalent vertebral fractures. Similar evidence does not exist to support the effectiveness of etidronate in fracture prevention, although etidronate treatment is associated with an increase in lumbar spine bone mineral density. Based on these studies, alendronate should be the current bisphosphonate of choice, whereas etidronate should be reserved for patients with a contraindication to alendronate or who are intolerant of alendronate therapy.
Hochberg
M C
MC
Departments of Medicine and Epidemiology and Preventive Medicine, the University of Maryland School of Medicine, and the Geriatric Research Education and Clinical Center, Veterans Affairs Maryland Health Care System, Baltimore, Maryland.