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Relative effectiveness of osteoporosis drugs for preventing nonvertebral fracture
Annals of Internal Medicine, 05/09/08

Cadarette SM et al. - Differences in fracture risk between risedronate or raloxifene and alendronate were small. Nasal calcitonin recipients may have a higher risk for nonvertebral fractures compared with alendronate recipients.

• Aim was to compare the relative effectiveness of osteoporosis treatments to reduce nonvertebral fracture risk among older adults
• 43,135 new recipients of oral bisphosphonates, nasal calcitonin, and raloxifene
• The mean age was 79 yrs, and 96% were women
• The primary outcome was nonvertebral fracture within 12 mos of treatment initiation
• Alendronate was the reference category in all analyses

• A total of 1051 nonvertebral fractures were observed within 12 mos
• No large differences in fracture risk were found between risedronate or raloxifene and alendronate
• Among those with a fracture history, raloxifene recipients experienced more nonvertebral fractures within 12 mos vs alendronate recipients
• Pts who received calcitonin experienced more nonvertebral fractures than those who received alendronate

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