Risedronate improves proximal femur bone density and geometry in patients with osteoporosis or osteopenia and clinical risk factors of fractures: a practice-based observational study

Takakuwa, Masayuki; Iwamoto, Jun; Konishi, Masahisa; Zhou, Qi; Itabashi, Kazuo

doi:10.1007/s00774-010-0196-x

Cited by 7 publications

(4 citation statements)

References 24 publications

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“…In the SABRE study, femoral BMD increased (?2%) after 2 years of anastrozole and risedronate therapy, whereas it decreased (although not significantly) in similar patients in the ARBI trial [22]. Given that femoral BMD decreased in our patients on anastrozole alone (group A) and did not change in those taking anastrozole and risedronate, anastrozole presumably has a negative effect on femoral BMD as well, whereas risedronate can prevent this BMD loss [23].…”

Section: Discussioncontrasting

confidence: 48%

Preventive effect of risedronate on bone loss and frailty fractures in elderly women treated with anastrozole for early breast cancer

et al. 2011

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The aim of this study was to assess the effect of adjuvant anastrozole, alone or associated with risedronate, on BMD and bone fracture risk in women more than 70 years old with hormone receptor-positive early breast cancer (EBC). In a group of 51 elderly women (aged 76.4 ± 5.0 years) considered for adjuvant aromatase inhibitors for EBC, 24 patients with T-scores ≥ -2 and no prevalent fractures received anastrozole 1 mg/day (group A), and 27 patients with T-scores < -2, or with T-scores ≥ -2 and prevalent fractures (group B), received anastrozole (1 mg/day) plus risedronate (35 mg/week). Both groups received supplementation with 1 g calcium carbonate and 800 IU vitamin D per day. Differences in BMD and frailty fractures were evaluated after 1 and 2 years. In group A, significant decreases in BMD were observed in the lumbar spine (Δ BMD, -0.030 ± 0.04 g/cm², P < 0.05), femoral neck (Δ BMD, -0.029 ± 0.05 g/cm², P < 0.05), and trochanter (Δ BMD, -0.026 ± 0.03 g/cm², P < 0.01) after 2 years. The greatest percent reduction in height (Hpr) emerged in the thoracic spine (3.6 ± 2.4%, P < 0.01), although only one incident vertebral fracture was observed. In group B, BMD increased in the lumbar spine (Δ BMD, 0.038 ± 0.04, P < 0.001), although no significant changes were seen in the hip regions. The decline in Hpr was negligible (about 1%). No incident fractures were observed at follow-up. In conclusion, anastrozole treatment for EBC in elderly women seems to have only mild negative effects on the femoral bone. Risedronate makes the use of anastrozole safer, even for osteopenic or osteoporotic elderly patients.

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Section: Discussioncontrasting

confidence: 48%

Preventive effect of risedronate on bone loss and frailty fractures in elderly women treated with anastrozole for early breast cancer

et al. 2011

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“…[6][7][8][9][10] We previously reported that 1 year of risedronate therapy significantly increased the BMD of the lumbar spine and femoral neck and improved geometric parameters including the CSMI and CSA. 11) We also reported that 3 years of risedronate therapy maintained or attenuated these improvements in the BMD, CSMI, and CSA. 12) However, very few studies have been performed in which the long-term effects of risedronate were evaluated using DXA incorporated with femoral geometric parameters.…”

mentioning

confidence: 56%

Five-Year Experience with Risedronate Therapy for Patients with Increased Fracture Risk: A Practice-Based Observational Study

Takakuwa¹,

Iwamoto

2015

Biol. Pharm. Bull.

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The purpose of this practice-based observational study was to examine the effects of long-term treatment with risedronate in patients with an increased fracture risk. Seventy patients (4 men and 66 postmenopausal women; mean age, 68.0 years) with osteoporosis or osteopenia and clinical risk factors for fractures were treated with risedronate at either 2.5 mg/d or 17.5 mg/week for 5 years. The bone mineral density (BMD) of the lumbar spine and proximal femur, and the structural geometric parameters of the proximal femur were evaluated by dual-energy X-ray absorptiometry with advanced hip assessment software at baseline and after each year of treatment. The lumbar spine BMD rapidly increased during the first year of the treatment and steadily increased throughout the 5-year treatment period. The BMD of the femoral neck and total hip also significantly increased during the first 3 and 2 years of treatment, respectively, then gradually declined and reached the baseline level after 5 years of treatment. The cross-sectional moment of inertia, cross-sectional area, and mean width of the femoral neck region of interest significantly increased during the first 2 years, and these increases were maintained throughout the 5-year treatment period. The femur strength index and section modulus also significantly increased following time courses similar to those of the above three parameters. These results suggest that risedronate produced both a sustained increase in the lumbar spine BMD and improvement in the femoral structural geometric parameters for 5 years of treatment.Key words risedronate; geometry; bone mineral density; advanced hip assessment; femur strength index Osteoporosis is a skeletal disease characterized by a decrease in bone strength and is associated with an increased fracture risk.1) Bone strength depends on two factors: bone mineral density (BMD) and bone quality. Bone quality is determined by both structural and material factors; structural factors include the macroscopic structure of cancellous bone and the porosity of cortical bone, whereas material factors include the extent of calcification, crystal size, matrix content, and microdamage. 1)Clinical assessment of bone geometry and microstructure has recently become possible because of marked progress in imaging technology. Software for advanced hip assessment (AHA) installed in dual-energy X-ray absorptiometry (DXA) systems is now widely used to noninvasively determine the structural geometric parameters of the proximal femur. 2,3)These structural parameters include the cross-sectional moment of inertia (CSMI) and cross-sectional area (CSA), from which the femur strength index (FSI) can be calculated. The FSI has predictive power for fracture risks in patients along with the BMD, 2,3) and the FSI obtained by DXA with AHA is reportedly well correlated with that obtained by quantitative computed tomography (QCT). 4,5) Risedronate has been widely used as a first-line drug in the treatment of osteoporosis. Current evidence based strictly on the principles ...

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Section: Cortical Geometrymentioning

confidence: 99%

“…At corticocancellous sites, the cortical shell thickness and area increases in osteoporotic women with bisphosphonate treatment [44,45]. For example, risedronate increased the cross-sectional moment of inertia and cross-sectional area of the femur in osteoporotic and osteopenic women and men after 4, 8, and 12 months of treatment [44]. In a recent report, however, cortical thickness of the femoral diaphysis was not increased with alendronate treatment for at least 5 years when measured by DXA [46], but DXA has limitations for measuring cortical thickness [47].…”

Section: Cortical Geometrymentioning

confidence: 99%

Atypical subtrochanteric femoral shaft fractures: role for mechanics and bone quality

Meulen

Boskey

2012

Arthritis Res Ther

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Bisphosphonates are highly effective agents for reducing osteoporotic fractures in women and men, decreasing fracture incidence at the hip and spine up to 50%. In a small subset of patients, however, these agents have recently been associated with 'atypical femoral fractures' (AFFs) in the subtrochanteric region or the diaphysis. These fractures have several atypical characteristics, including occurrence with minimal trauma; younger age than typical osteoporotic fractures; occurrence at cortical, rather than cancellous sites; early radiographic appearance similar to that of a stress fracture; transverse fracture pattern rather than the familiar spiral or transverse-oblique morphologies; initiation on the lateral cortex; and high risk of fracture on the contralateral side, at the same location as the initial fracture. Fracture is a mechanical phenomenon that occurs when the loads applied to a structure such as a long bone exceed its load-bearing capacity, either due to a single catastrophic overload (traumatic failure) or as a result of accumulated damage and crack propagation at sub-failure loads (fatigue failure). The association of AFFs with no or minimal trauma suggests a fatigue-based mechanism that depends on cortical cross-sectional geometry and tissue material properties. In the case of AFFs, bisphosphonate treatment may alter cortical tissue properties, as these agents are known to alter bone remodeling. This review discusses the use of bisphosphonates, their effects on bone remodeling, mechanics and tissue composition, their significance as an effective therapy for osteoporosis, and why these agents may increase fracture risk in a small population of patients.

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Risedronate improves proximal femur bone density and geometry in patients with osteoporosis or osteopenia and clinical risk factors of fractures: a practice-based observational study

Cited by 7 publications

References 24 publications

Preventive effect of risedronate on bone loss and frailty fractures in elderly women treated with anastrozole for early breast cancer

Preventive effect of risedronate on bone loss and frailty fractures in elderly women treated with anastrozole for early breast cancer

Five-Year Experience with Risedronate Therapy for Patients with Increased Fracture Risk: A Practice-Based Observational Study

Atypical subtrochanteric femoral shaft fractures: role for mechanics and bone quality

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