Alendronate Could Reduce Hip Fracture Risk in Patients Taking Glucocorticoids

Alendronate was found to reduce the risk of hip fracture among older patients taking medium to high doses of prednisolone, according to the findings of a new study.

In the retrospective cohort study, the researchers identified 1802 patients who were prescribed alendronate after at least 3 months of oral prednisolone treatment, and 1802 patients who were not prescribed alendronate but were taking prednisolone using a national database. The mean age was 79.9 years, and 2524 (70%) of the patients were women. Incident of hip fracture was assessed as the primary outcomes during the median 1.32 years of follow-up.
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Twenty-seven hip fractures occurred among patients in the alendronate group, and 73 occurred in patients who did not receive alendronate, (incidence rates 9.5 hip fractures per 1000 person-years vs 27.2 per 1000 person-years, respectively). 

In multivariable-adjusted analyses, alendronate was associated with a lower risk of hip fractures (hazard ratio 0.35), but was not associated with an increased risk for mild upper gastrointestinal tract symptoms or peptic ulcers.

There was only 1 case of femoral shaft fracture in both groups, and no cases of drug-induced osteonecrosis.

“Among older patients using medium to high doses of prednisolone, alendronate treatment was associated with a significantly lower risk of hip fracture over a median of 1.32 years,” the researchers concluded. “Although the findings are limited by the observational study design and the small number of events, these results support the use of alendronate in this patient group.”

—Melissa Weiss

Reference:

Axelsson KF, Nilsson A, Wedel H, et al. Association between alendronate use and hip fracture risk in older patients using oral prednisolone [published online July 11, 2017]. JAMA. doi:10.1001/jama.2017.8040.