The osteoporosis medication alendronate was found to reduce the risk of hip fracture by 65% in older patients using glucocorticoids. The finding comes from a new study published in the Journal of the American Medical Association.

Using a national health evaluation database from Sweden, researchers were able to conduct a retrospective cohort study of 1,802 patients ≥65 years who were prescribed alendronate after at least 3 months of treatment with oral prednisolone (≥5mg/d). Propensity score matching was used to select a further 1,802 patients with the same prednisolone dose and treatment time but who had not used alendronate.

Results showed that after a mean follow-up of 1.32 years, there were 27 hip fractures in the alendronate group and 73 in the non-alendronate group; this corresponded to incident rates of 9.5 (95% CI, 6.5–13.9) and 27.2 (95% CI, 21.6–34.2) fractures per 1000 person-years, respectively. Additionally, the multivariable-adjusted Cox model showed that alendronate was associated with a lower risk of hip fracture (hazard ratio, 0.35; 95% CI, 0.22–0.54). The study also found no increased risk of side effects in the alendronate group. 

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“The number of patients receiving [alendronate] treatment is quite low at present, but we are hoping this study will mean more prednisolone patients will receive the fracture-preventing treatment,” said Kristian Axelsson, resident physician at Skaraborgs Hospital, Sweden, and co-author of the study.

The researchers acknowledged the limitations of observational studies, however they still concluded that their results support the use of alendronate in patients who receive oral glucocorticoid treatment.

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