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Osteoporosis International
Published in: Osteoporosis International 8/2013

01-08-2013 | Original Article

Effectiveness of risedronate and alendronate on nonvertebral fractures: an observational study through 2 years of therapy

Authors: R. Lindsay, N. B. Watts, J. L. Lange, P. D. Delmas, S. L. Silverman

Published in: Osteoporosis International | Issue 8/2013

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Abstract

Summary

This observational study showed that after 2 years, both risedronate and alendronate lowered the risk of hip and nonvertebral fractures compared with patients filling in a single bisphosphonate prescription.

Introduction

Post hoc analyses of the placebo-controlled trials suggested earlier effects for risedronate (6–12 months) than for alendronate (18–24 months). The present study extends our 1-year observational data that confirmed an earlier fracture reduction with risedronate and evaluated the absolute and relative effectiveness of alendronate and risedronate in clinical practice over 2 years.

Methods

We observed three cohorts of women aged 65 years and older who initiated once-a-week dosing of bisphosphonate therapy; (1) patients adherent to alendronate (n = 21,615), (2) patients adherent to risedronate (n = 12,215), or (3) patients filling only a single bisphosphonate prescription (n = 5,390) as a referent population. Proportional hazard modeling compared the incidence of hip and nonvertebral fractures among the cohorts over 2 years after the initial prescription.

Results

In this cohort, we previously showed at 12 months a significant reduction of hip and nonvertebral fractures with risedronate but not with alendronate. At the end of 2 years, the cumulative incidence of hip fractures in the referent cohort was 1.9 %, and incidence of nonvertebral fractures was 6.3 %. Relative to the referent, 6 months after initiating therapy and continuing through 2 years, both risedronate and alendronate cohorts had approximately a 45 % lower incidence of hip fractures and a 30 % lower incidence of nonvertebral fractures.

Conclusion

These observations suggest that both risedronate and alendronate are effective at reducing the risk of hip and nonvertebral fracture after 2 years of treatment and support the post hoc analyses of placebo-controlled trials indicating an earlier effect of risedronate.
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Metadata
Title
Effectiveness of risedronate and alendronate on nonvertebral fractures: an observational study through 2 years of therapy
Authors
R. Lindsay
N. B. Watts
J. L. Lange
P. D. Delmas
S. L. Silverman
Publication date
01-08-2013
Publisher
Springer London
Published in
Osteoporosis International / Issue 8/2013
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-013-2332-7

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