Risedronate therapy prevents corticosteroid‐induced bone loss : A twelve‐month, multicenter, randomized, double‐blind, placebo‐controlled, parallel‐group study

• Published in: Arthritis and rheumatism Vol. 42; no. 11; pp. 2309 - 2318
• Main Authors: Cohen, Stanley, Levy, Robert M., Keller, Michael, Boling, Eugene, Emkey, Ronald D., Greenwald, Maria, Zizic, Thomas M., Wallach, Stanley, Sewell, Kathryn L., Lukert, Barbara P., Axelrod, Douglas W., Chines, Arkadi A.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York John Wiley & Sons, Inc 01-11-1999; Wiley
• Subjects: Adolescent; Adrenal Cortex Hormones - adverse effects; Adult; Aged; Aged, 80 and over; Analysis of Variance; Biological and medical sciences; Biomarkers; Bone Resorption - chemically induced; Bone Resorption - prevention & control; Bones, joints and connective tissue. Antiinflammatory agents; Calcium Channel Blockers - adverse effects; Calcium Channel Blockers - therapeutic use; Demography; Double-Blind Method; Etidronic Acid - adverse effects; Etidronic Acid - analogs & derivatives; Etidronic Acid - therapeutic use; Female; Humans; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Risedronate Sodium; Human; Corticosteroid; Toxicity; Treatment efficiency; Diseases of the osteoarticular system; Diphosphonic acid derivatives; Bone disease; Bisphosphonates; Long term; Prevention; Chemotherapy; Association; Treatment; Risedronic acid; Clinical trial; Densitometry; Osteopenia
• ISSN: 0004-3591; 1529-0131
• DOI: 10.1002/1529-0131(199911)42:11<2309::AID-ANR8>3.0.CO;2-K

Objective
Risedronate, a new pyridinyl bisphosphonate, is a potent antiresorptive bone agent. This study examines the safety and efficacy of daily, oral risedronate therapy for the prevention of corticosteroid‐induced bone loss.
Methods
This multicenter, randomized, double‐blind, placebo‐controlled, parallel‐group study was conducted in 224 men and women who were initiating long‐term corticosteroid treatment. Patients received either risedronate (2.5 mg or 5 mg) or placebo daily for 12 months. Each patient also received 500 mg of elemental calcium daily. The primary outcome measure was the percentage of change in lumbar spine bone mineral density (BMD). Secondary measures included proximal femur BMD and incidence of vertebral fractures.
Results
After 12 months, the lumbar spine BMD (mean ± SEM) did not change significantly compared with baseline in the 5‐mg (0.6 ± 0.5%) or the 2.5‐mg (−0.1 ± 0.7%) risedronate groups, while it decreased in the placebo group (−2.8 ± 0.5%; P < 0.05). The mean differences in BMD between the 5‐mg risedronate and the placebo groups were 3.8 ± 0.8% at the lumbar spine (P < 0.001), 4.1 ± 1.0% at the femoral neck (P < 0.001), and 4.6 ± 0.8% at the femoral trochanter (P < 0.001). A trend toward a decrease in the incidence of vertebral fracture was observed in the 5‐mg risedronate group compared with the placebo group (5.7% versus 17.3%; P = 0.072). Risedronate was well tolerated, and the incidence of upper gastrointestinal adverse events was comparable among the 3 groups.
Conclusion
Risedronate therapy prevents bone loss in patients initiating long‐term corticosteroid treatment.