title: Response of postpoliomyelitis patients to bisphosphonate treatment.
abstract: OBJECTIVE
  To evaluate (1) the rate of change of bone mineral density (BMD) at the hip in postpolio patients treated with bisphosphonates compared with the rate of change in BMD in (a) postpolio patients not treated with bisphosphonates and (b) non-postpolio patients treated with bisphosphonates; and (2) to compare the fracture rate in postpolio patients before and after treatment.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  University-affiliated hospital postpolio clinic and bone metabolism clinic.
  
  
  METHODS
  Patients with at least 2 BMD assessments. We included 144 postpolio patients and 112 non-postpolio patients. For the fracture analysis, 32 postpolio patients with a history of fractures and treatment with bisphosphonates were included.
  
  
  METHODS
  The effect of treatment on BMD in postpolio patients was analyzed with use of a multiple linear regression model and a mixed effects model, with the rate of change in hip BMD and the change in BMD from baseline, respectively, as the dependent variables. The effect of treatment on occurrence of fractures in postpolio patients was analyzed with use of conditional logistic regression and Poisson regression.
  
  
  METHODS
  BMD measurements at the femoral neck (g/cm²) and occurrence of fractures before and after initiation of treatment.
  
  
  RESULTS
  In an adjusted model, postpolio patients treated with bisphosphonates (54/144) had a greater rate of change in BMD (0.031 g/cm²/year; 95% confidence interval 0.010-0.052) compared with nontreated postpolio patients. The effect of treatment in postpolio patients was similar to that in non-postpolio patients. Evidence indicated that treated postpolio patients have a lower risk of fracture after treatment (odds ratio 0.3, P = .046; rate ratio 0.4, P = .183).
  
  
  CONCLUSIONS
  In this retrospective study, it was found that treatment with oral bisphosphonates significantly increases BMD at the hip in postpolio patients. The effect of bisphosphonate treatment appears to be similar in postpolio patients compared with a control group without polio. Treatment with bisphosphonates may have a protective effect on fracture risk in this population.
authors.affiliation: Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University Health Centre, McGill University, Montreal, QC, Canada.
authors.forename: Arodi
authors.initials: A
authors.lastname: Alvarez
authors.forename: Richard
authors.initials: R
authors.lastname: Kremer
authors.forename: Deborah R
authors.initials: DR
authors.lastname: Weiss
authors.forename: Andrea
authors.initials: A
authors.lastname: Benedetti
authors.forename: Muriel
authors.initials: M
authors.lastname: Haziza
authors.forename: Daria A
authors.initials: DA
authors.lastname: Trojan
mesh_terms: D000284:Administration, Oral; D019386:Alendronate / Q000627:therapeutic use; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D012968:Etidronic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D005260:Female; D050723:Fractures, Bone / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D016262:Postpoliomyelitis Syndrome / Q000150:complications / Q000188:drug therapy*; D012189:Retrospective Studies; D000068296:Risedronic Acid
chemical_list: D050071:Bone Density Conservation Agents; D000068296:Risedronic Acid; D012968:Etidronic Acid; D019386:Alendronate