Etidronate for treating and preventing postmenopausal osteoporosis

Cranney, Ann; Adachi, Jonathan D.; Griffith, Lauren; Guyatt, Gordon; Krolicki, N; Robinson, Vivian; Shea, Beverley; Wells, George A.

doi:10.1002/14651858.cd003376

Cited by 24 publications

(4 citation statements)

References 33 publications

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“…According to the results of a meta-analysis of randomized controlled trials in foreign countries to test the efficacy of etidronate treatment for osteoporosis in postmenopausal women,1 etidronate treatment reduced vertebral fractures (relative risk [RR]: 0.60), but had no effect on non-vertebral fractures (RR: 1.00). Etidronate, relative to a control, increased the bone mineral density (BMD) by 4.27% in the lumbar spine, 2.19% in the femoral neck, and 0.97% in the total body after 3 years of treatment.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Oral Etidronate for Skeletal Diseases in Japan

2005

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Etidronate is an oral bisphosphonate compound that is known to reduce bone resorption through the inhibition of osteoclastic activity. The efficacy of etidronate for involutional (postmenopausal and senile) and glucocorticoid-induced osteoporosis, as well as that for other skeletal diseases, was reviewed in Japanese patients. Cyclical etidronate treatment (200 mg or 400 mg/day for 2 weeks about every 3 months) increases the lumbar bone mineral density (BMD) in patients with involutional osteoporosis and prevents incident vertebral fractures in patients with glucocorticoid-induced osteoporosis. The losses of the lumbar BMD in patients with liver cirrhosis and the metacarpal BMD in hemiplegic patients after stroke are prevented, and the lumbar BMD is possibly increased, preventing fragile fractures in adult patients with osteogenesis imperfecta type I. Furthermore, proximal bone resorption around the femoral stem is reduced and some complications may be prevented in patients who undergo cementless total hip arthroplasty. Oral etidronate treatment may also help to transiently relieve metastatic cancer bone pain followed by a decrease in abnormally raised bone resorption in patients with painful bone metastases from primary cancer sites, such as the lung, breast and prostate. Thus, oral etidronate treatment is suggested to be efficacious for osteoporosis, as well as other skeletal diseases associated with increased bone resorption, in Japanese patients. Randomized controlled trials needed to be conducted on a large number of patients to confirm these effects.

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Section: Introductionmentioning

confidence: 99%

Efficacy of Oral Etidronate for Skeletal Diseases in Japan

2005

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“…The results show that etidronate increases bone density in the lumbar spine and femoral neck compared with placebo. The combined results of fracture reduction with etidronate suggest a decrease in vertebral fractures, but there is no evidence of effect on nonvertebral fractures 145…”

Section: Pharmacological Therapiesmentioning

confidence: 95%

Prevention and treatment of osteoporosis in inflammatory bowel disease

Lichtenstein

Sands

Pazianas

2006

Inflammatory Bowel Diseases

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The following are guidelines for evaluation and consideration for treatment of patients with inflammatory bone disease (IBD) after bone mineral density (BMD) measurements. The Crohn's & Colitis Foundation of America (CCFA) has indicated that its recommendations are intended to serve as reference points for clinical decision-making, not as rigid standards, limits, or rules. They should not be interpreted as quality standards.

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“…In fact, an annual 5 mg intravenous infusion of zoledronic acid reduced the risk of vertebral, hip or nonvertebral fractures by 70%, 41% and 25%, respectively, 31 and 400 mg daily doses of oral etidronate for 14-20 days per quarter year and 2.5 mg daily or 150 mg monthly doses of oral ibandronate reduced the risk of vertebral fractures by 41% and 50-52% for each drug, respectively. 16,32 In addition, when high doses of ibandronate were compared to low doses-that is, an annual cumulative exposure ≥10.8 mg (150 mg monthly) versus 5.5 mg (2.5 mg daily)-the high dose reduced the incidence of nonvertebral fractures by 38% more than the low dose. 33 In a pooled analysis of two RCTs, oral clodronate (800 mg daily) significantly reduced the risk of vertebral fractures by 40% and that of non vertebral fractures by 21%.…”

Section: Bisphosphonatesmentioning

confidence: 99%

“…Randomized controlled trials (RCTs) provide good evidence for the efficacy of antiresorptive therapies in preventing fracture among postmenopausal women with osteoporosis. [14][15][16][17][18] In men, the limited evidence available suggests that antiresorptive therapy offers protective skeletal effects similar to those observed in women. [19][20][21] Nevertheless, some clinicians remain unconvinced about the efficacy of antiresorptive therapies in real-world populations of patients, 22 and about which groups of patients should be treated with these agents.…”

Section: Introductionmentioning

confidence: 99%

Antiresorptive therapies for osteoporosis: a clinical overview

2011

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Antiresorptive therapies are used to increase bone strength in individuals with osteoporosis and include five principal classes of agents: bisphosphonates, estrogens, selective estrogen receptor modulators (SERMs), calcitonin and monoclonal antibodies such as denosumab. However, no head-to-head studies have compared different antiresorptive agents using fracture as an end point. Bisphosphonates, which have proven antifracture efficacy and a good safety profile, are the most widely used first-line antiresorptive therapy and are recommended for patients with osteoporosis, a prior fragility fracture or osteopenia, as well as individuals with a high risk of fracture. Denosumab, which also has good antifracture efficacy, is another possible first-line therapy, although long-term safety data are lacking. However, no single antiresorptive therapy is currently appropriate for all patients or clearly superior to other therapies. Antiresorptive agents such as estrogens, SERMs (in postmenopausal women) and calcitonin are considered to be second-line agents that are appropriate in special circumstances. Clinicians should determine the most appropriate pharmacological therapy after a careful assessment of the risk:benefit profiles of these drugs in each patient. In addition, patients should receive a detailed explanation of the treatment goals, so that the therapeutic benefit can be maximized through good compliance and persistence.

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Etidronate for treating and preventing postmenopausal osteoporosis

Cited by 24 publications

References 33 publications

Efficacy of Oral Etidronate for Skeletal Diseases in Japan

Efficacy of Oral Etidronate for Skeletal Diseases in Japan

Prevention and treatment of osteoporosis in inflammatory bowel disease

Antiresorptive therapies for osteoporosis: a clinical overview

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