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Alendronate, prednisolone combination lowers fracture risk
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Adults treated with prednisolone and alendronate had reduced risk for hip fracture, major osteoporotic fracture, any fracture and nonvertebral fracture compared with adults treated with prednisolone only, according to findings published in JAMA.
Mattias Lorentzon, MD, PhD, professor of geriatric medicine at the Institute of Medicine, Gothenburg University and a senior physician at the Osteoporosis Clinic at the Sahlgrenska University Hospital, Mölndal, Sweden, and colleagues evaluated data from the Senior Alert database on 1,802 adults prescribed alendronate after at least 3 months of oral prednisolone treatment (5 mg per day) and 1,802 without alendronate use assigned prednisolone with the same dose and treatment time criteria. Mean age of participants was 79.9 years, and 70% were women. Follow-up was conducted between 2008 and 2014 for a median of 1.32 years.
The incidence rate for hip fracture was lower in the alendronate group (9.5 fractures per 1,000 person-years) compared with the non-alendronate group (27.2 per 1,000 person-years) for a lower risk for hip fracture in the alendronate group compared with the non-alendronate group (HR = 0.35; 95% CI, 0.23-0.55).
Alendronate treatment significantly reduced the risk for major osteoporotic fracture (HR = 0.53; 95% CI, 0.39-0.74), any fracture (HR = 0.6; 95% CI, 0.48-0.76) and nonvertebral fracture (HR = 0.57; 95% CI, 0.45-0.73) compared with treatment with prednisolone only.
The risk for death was lower in participants assigned to alendronate and prednisolone compared with those assigned prednisolone only (HR = 0.88; 95% CI, 0.79-0.98).
“Our study supports the use of alendronate in older patients taking oral prednisolone in order to reduce the risk of hip fracture,” Lorentzon told Endocrine Today. “We hope that this study will lead to better preventive care of older patients taking oral glucocorticoids.” – by Amber Cox
For more information:
Mattias Lorentzon, MD, PhD, can be reached at mattias.lorentzon@medic.gu.se.
Disclosures: Lorentzon reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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