Among older patients using medium to high doses of the anti-inflammatory steroid prednisolone, treatment with the osteoporosis drug alendronate was associated with a significantly lower risk of hip fracture, according to a study published by JAMA.
Although glucocorticoid therapy is widely used to treat inflammatory conditions, it can lead to rapid bone loss and is associated with an increased rate of fracture. Evidence is lacking regarding the efficacy of alendronate to protect against hip fracture in older patients using glucocorticoids. Using a national database, Mattias Lorentzon, M.D., Ph.D., of the University of Gothenburg, Sweden, and colleagues identified 1,802 patients who were prescribed alendronate after at least 3 months of oral prednisolone treatment, and 1,802 patients taking prednisolone without alendronate use.
The average age of the patients was 80 years; 70 percent were women. After a median follow-up of 1.3 years, there were 27 hip fractures in the alendronate group and 73 in the no-alendronate group. Analyses indicated that alendronate treatment for a median duration of 2.9 years was associated with lower risk of hip fracture than no alendronate treatment. Greater duration of treatment was associated with a lower risk of hip fracture.
"Although the findings are limited by the observational study design and the small number of events, these results support the use of alendronate in this patient group," the authors write.
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(doi:10.1001/jama.2017.8040)
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Journal
JAMA