The Effect of Alendronate, Risedronate, and Raloxifene on Renal Functions, Based on the Cockcroft and Gault Method, in Postmenopausal Women

Abstract

Background. Oral alendronate, risedronate, and raloxifene are effective treatment options in the management of postmenopausal osteoporosis. There is little previously reported about the renal safety profiles of these three agents in osteoporosis. We aimed to assess the risk of renal toxicity associated with oral alendronate, risedronate, and raloxifene in the treatment of osteoporosis, prospectively. Methods. One hundred and twentyseven patients with osteoporosis and osteopenia according to lumbar or femoral-neck bone mineral density t score were enrolled in the study. The patients were randomized to alendronate 70 mg once weekly (n = 47), risedronate 35 mg once weekly (n = 44), or raloxifene 60 mg per day (n = 36) for one year. Preliminary screening included medical history, physical examination, lumbar and femoral bone mineral densitometry measurement, and blood biochemical tests, including renal function tests. The biochemical markers were then assessed at the end of 12 months. Results. There was no significant difference between basal and final renal function parameters of each group. Also these parameters did not differ between the three groups after 12 months of treatment period. Conclusions. These results demonstrate that alendronate, risedronate, and raloxifene are all safe drugs for renal functions in the treatment of osteoporosis.

Alendronate versus Raloxifene for Postmenopausal Women: A Meta-Analysis of Seven Head-to-Head Randomized Controlled Trials

“…From the remaining 507 articles, 497 were excluded since they did not fulfill the selection criteria based on their titles and abstracts. After full-text checking of the rest of 10 RCTs [15–21, 25–27], 3 RCTs were excluded as their outcomes did not meet the inclusion criteria [25–27]. Finally, 7 studies with usable information were included in our meta-analysis [15–21] (Figure 1).…”

Gastrointestinal and renal side effects of bisphosphonates: differentiating between no proof of difference and proof of no difference

“…The criterion for demonstrating equivalence is when both extremes of the confidence interval remain within the two vertical dotted lines. Data from Yanik et al [19] (one trial). Numerical values of mean difference −0.4 ml/min (95 % CI −10.3 to +9.5; 90 % CI −8.7 to +7.9).…”

“…As regards renal adverse effects, while many studies have previously reported the occurrence of kidney dysfunction concomitant with the use of bisphosphonates, one limitation is that different outcome measures were used [19,20], and this makes it impossible to pool data from different trials and perform indirect comparisons. Further data are needed to clarify the renal safety profile of the overall class of bisphosphonates.…”

“…Further data are needed to clarify the renal safety profile of the overall class of bisphosphonates. Bisphosphonate-induced nephrotoxicity is a source of concern, particularly for intravenous drugs; as pointed out in the literature [19,20], this type of nephrotoxicity has different implications from the toxicity associated with oral agents on the long term. On the other hand, as regards oral formulations, very few data are available on their renal safety, especially when the treatment covers several years.…”

“…Just a single randomized trial (published by Yanik et al [19]) was adequate for our purposes. In this trial, Yanik et al evaluated the safety of two bisphosphonates (alendronate and risedronate) by determining the mean difference of glomerular filtration rate over 12 months in 91 patients.…”