Which Osteoporosis Medications Help Prevent Fractures in the Spine and Hip?
A Look at Antiresorptive Agents for Patients at an Increased Risk of Fracture
In a recent study, researchers examined the efficacy of powerful antiresorptive agents that are currently available to help prevent fractures—including vertebral and hip fractures—in patients living in Japan who have an increased risk of fracture. Many of the patients included in the study had involutional or postmenopausal osteoporosis.
Researchers published their findings in an article in the March 2012 issue of Drugs & Aging. The article is called “Efficacy of antiresorptive agents for preventing fractures in Japanese patients with an increased fracture risk: review of the literature.”
They used PubMed to search for randomized controlled trials (RCTs) they could include in their study.
Articles included in the study were identified using the following search terms: alendronate, bazedoxifene, etidronate, fracture, Japan, minodronate, raloxifene, and risedronate.
Inclusion criteria for this study were papers written in English, papers that had more than 50 participants per group, and papers that involved a study period of more than 1 year.
After analyzing potential RCTs, researchers indentified 14 RCTs that met these inclusion criteria.
They looked at the effectiveness of antiresorptive agents for preventing 3 types of fractures: vertebral, non-vertebral, and hip fractures.
Using the data from these RCTs, researchers found evidence that raloxifene reduced incidence of clinical vertebral fractures. On the other hand, etidronate, alendronate, and minodronate—but not bazedoxifene—decreased incidence of morphometric vertebral fractures in patients who have involutional or postmenopausal osteoporosis.
They noted that in the head-to-head trials, alendronate and raloxifene had similar effectiveness for preventing vertebral fractures in patients who have postmenopausal osteoporosis. However, they found that risedronate was not an inferior treatment to etidronate for decreasing incidence of morphometric vertebral fractures in patients who have involutional osteoporosis.
In addition, researchers observed that alendronate decreased incidence of hip fractures in patients who have Parkinson’s disease. They also observed that risedronate decreased incidence of both non-vertebral fractures and hip fractures in patients who have Alzheimer’s disease or those that have had a stroke.
The research team concluded that their literature review validated the effectiveness of 3 medications for preventing vertebral fractures: etidronate, minodronate, and raloxifene. Their findings also confirmed the effectiveness of alendronate for preventing both vertebral and hip fractures. Additionally, their findings validated the effectiveness of risedronate for preventing vertebral, non-vertebral, and hip fractures in patients living in Japan who are at an increased fracture risk.