HealthDay News — Drug holidays after long-term risedronate are associated with a small increase in the risk for hip fracture compared with drug holidays after long-term alendronate, according to a study published online January 11 in the Annals of Internal Medicine.

Kaleen N. Hayes, PharmD, PhD, from the Brown University School of Public Health in Providence, Rhode Island, and colleagues conducted a population-based, matched, cohort study to examine the comparative risks for fracture during a drug holiday after long-term (three or more years) risedronate vs alendronate therapy among persons aged 66 years or older. Data were included for 25,077 propensity score-matched pairs (mean age, 81 years; 81% women).

The researchers found that the rates of hip fracture were higher among risedronate vs alendronate drug holidays (12.4 vs 10.6 events per 1000 patient-years; hazard ratio, 1.18; 95 percent confidence interval, 1.04 to 1.34). When any fracture was included as the outcome (hazard ratio, 1.07; 95% CI, 1.00 to 1.16) and with shorter drug holidays (one year: hazard ratio, 1.03 [95% CI, 0.85 to 1.24]; 2 years: hazard ratio, 1.14 [95% CI, 0.96 to 1.32]), the association was attenuated.

“We emphasize that our results do not indicate that alendronate therapy should be preferred over risedronate therapy,” the authors write. “The decision to initiate alendronate or risedronate therapy is driven by the prescriber and may be influenced by many patient-specific considerations.”

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