Objective. Risedronate, a new pyridinyl bisphos-phonate, is a potent antiresorptive bone agent. This study examines the safety and efficacy of daily, oral risedronate therapy for the prevention of corticosteroid-induced bone loss. Methods. This multicenter, randomized, double-blind, placebo-controlled, parallel-group study was conducted in 224 men and women who were initiating long-term corticosteroid treatment. Patients received either risedronate (2.5 mg or 5 mg) or placebo daily for 12 months. Each patient also received 500 mg of elemental calcium daily. The primary outcome measure was the percentage of change in lumbar spine bone mineral density (BMD). Secondary measures included proximal femur BMD and incidence of vertebral fractures. Results. After 12 months, the lumbar spine BMD (mean SEM) did not change significantly compared with baseline in the 5-mg (0.6 0.5%) or the 2.5-mg (0.1 0.7%) risedronate groups, while it decreased in the placebo group (2.8 0.5%; P < 0.05). The mean differences in BMD between the 5-mg risedronate and the placebo groups were 3.8 0.8% at the lumbar spine (P < 0.001), 4.1 1.0% at the femoral neck (P < 0.001), and 4.6 0.8% at the femoral trochanter (P < 0.001). A trend toward a decrease in the incidence of vertebral fracture was observed in the 5-mg risedronate group compared with the placebo group (5.7% versus 17.3%; P 0.072). Risedronate was well tolerated, and the incidence of upper gastrointestinal adverse events was comparable among the 3 groups. Conclusion. Risedronate therapy prevents bone loss in patients initiating long-term corticosteroid treatment. Corticosteroid therapy is used extensively to treat patients with a variety of medical conditions, most of whom require corticosteroid therapy for its potent anti-inflammatory and immunosuppressive properties. Although this therapy is valuable and necessary for many patients, the administration of corticosteroids for prolonged periods is associated with a number of adverse effects, one of the most debilitating of which is bone loss, which can result in fractures (1,2). Bone loss in patients taking corticosteroids appears to occur as a result of both reduced bone formation , which is attributed to direct inhibition of osteoblas

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