Rheumatology Medical News about bisphosphonates;clinical fracture incidence

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Longitudinal change in clinical fracture incidence after initiation of bisphosphonates
Osteoporosis International, 09/03/09

Abelson A et al. – Differences in the baseline fracture incidence among the cohorts may reflect differences in the risk profile of patients prescribed each bisphosphonate. The reductions observed in fracture incidence over time within each cohort suggest that the effectiveness of each bisphosphonate in clinical practice has been consistent with their efficacies demonstrated in randomized controlled trials.

Methods

Administrative billing data were used to follow three cohorts of women aged 65 and older (total n?=?210,144) after starting therapy either on alendronate, risedronate, or ibandronate
Within each cohort, the baseline incidence of clinical fractures at the hip, vertebral, and nonvertebral sites was defined by the initial 3-month period after starting therapy
Relative to these baselines, we then compared the fracture incidence during the subsequent 12 months on therapy

Results

Relative to the baseline incidence, fracture incidence was significantly lower in the subsequent 12 months in both cohorts of alendronate (18% lower at hip, 28% at nonvertebral sites, and 57% at vertebral sites) and risedronate (27% lower at hip, 21% at nonvertebral sites, and 54% at vertebral sites)
In the ibandronate cohort, the fracture incidence was lower (31%) only at vertebral sites

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