Risedronate therapy prevents corticosteroid-induced bone loss: A twelve- month, multicenter, randomized, double-blind, placebo-controlled, parallel- group study

Stanley Cohen, Robert M. Levy, Michael Keller, Eugene Boling, Ronald D. Emkey, Maria Greenwald, Thomas M. Zizic, Stanley Wallach, Kathryn L. Sewell, Barbara P. Lukert, Douglas W. Axelrod, Arkadi A. Chines

Research output: Contribution to journalArticle

Abstract

Objective. Risedronate, a new pyridinyl bisphosphonate, is a potent antiresorptive bone agent. This study examines the safety and efficacy of daily, oral risedronate therapy for the prevention of corticosteroid-induced bone loss. Methods. This multicenter, randomized, double-blind, placebo- controlled, parallel-group study was conducted in 224 men and women who were initiating long-term corticosteroid treatment. Patients received either risedronate (2.5 mg or 5 mg) or placebo daily for 12 months. Each patient also received 500 mg of elemental calcium daily. The primary outcome measure was the percentage of change in lumbar spine bone mineral density (BMD). Secondary measures included proximal femur BMD and incidence of vertebral fractures. Results. After 12 months, the lumbar spine BMD (mean ± SEM) did not change significantly compared with baseline in the 5-mg (0.6 ± 0.5%) or the 2.5-mg (-0.1 ± 0.7%) risedronate groups, while it decreased in the placebo group (-2.8 ± 0.5%; P <0.05). The mean differences in BMD between the 5-mg risedronate and the placebo groups were 3.8 ± 0.8% at the lumbar spine (P <0.001), 4.1 ± 1.0% at the femoral neck (P <0.001), and 4.6 ± 0.8% at the femoral trochanter (P <0.001). A trend toward a decrease in the incidence of vertebral fracture was observed in the 5-mg risedronate group compared with the placebo group (5.7% versus 17.3%; P = 0.072). Risedronate was well tolerated, and the incidence of upper gastrointestinal adverse events was comparable among the 3 groups. Conclusion. Risedronate therapy prevents bone loss in patients initiating long-term corticosteroid treatment.

Original languageEnglish (US)
Pages (from-to)2309-2318
Number of pages10
JournalArthritis and Rheumatism
Volume42
Issue number11
DOIs
StatePublished - Nov 1999
Externally publishedYes

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Adrenal Cortex Hormones
Placebos
Bone and Bones
Bone Density
Spine
Therapeutics
Femur
Incidence
Bone Density Conservation Agents
Risedronate Sodium
Femur Neck
Diphosphonates
Thigh
Outcome Assessment (Health Care)
Calcium
Safety

ASJC Scopus subject areas

  • Immunology
  • Rheumatology

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Risedronate therapy prevents corticosteroid-induced bone loss : A twelve- month, multicenter, randomized, double-blind, placebo-controlled, parallel- group study. / Cohen, Stanley; Levy, Robert M.; Keller, Michael; Boling, Eugene; Emkey, Ronald D.; Greenwald, Maria; Zizic, Thomas M.; Wallach, Stanley; Sewell, Kathryn L.; Lukert, Barbara P.; Axelrod, Douglas W.; Chines, Arkadi A.

In: Arthritis and Rheumatism, Vol. 42, No. 11, 11.1999, p. 2309-2318.

Research output: Contribution to journalArticle

Cohen, Stanley ; Levy, Robert M. ; Keller, Michael ; Boling, Eugene ; Emkey, Ronald D. ; Greenwald, Maria ; Zizic, Thomas M. ; Wallach, Stanley ; Sewell, Kathryn L. ; Lukert, Barbara P. ; Axelrod, Douglas W. ; Chines, Arkadi A. / Risedronate therapy prevents corticosteroid-induced bone loss : A twelve- month, multicenter, randomized, double-blind, placebo-controlled, parallel- group study. In: Arthritis and Rheumatism. 1999 ; Vol. 42, No. 11. pp. 2309-2318.
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abstract = "Objective. Risedronate, a new pyridinyl bisphosphonate, is a potent antiresorptive bone agent. This study examines the safety and efficacy of daily, oral risedronate therapy for the prevention of corticosteroid-induced bone loss. Methods. This multicenter, randomized, double-blind, placebo- controlled, parallel-group study was conducted in 224 men and women who were initiating long-term corticosteroid treatment. Patients received either risedronate (2.5 mg or 5 mg) or placebo daily for 12 months. Each patient also received 500 mg of elemental calcium daily. The primary outcome measure was the percentage of change in lumbar spine bone mineral density (BMD). Secondary measures included proximal femur BMD and incidence of vertebral fractures. Results. After 12 months, the lumbar spine BMD (mean ± SEM) did not change significantly compared with baseline in the 5-mg (0.6 ± 0.5{\%}) or the 2.5-mg (-0.1 ± 0.7{\%}) risedronate groups, while it decreased in the placebo group (-2.8 ± 0.5{\%}; P <0.05). The mean differences in BMD between the 5-mg risedronate and the placebo groups were 3.8 ± 0.8{\%} at the lumbar spine (P <0.001), 4.1 ± 1.0{\%} at the femoral neck (P <0.001), and 4.6 ± 0.8{\%} at the femoral trochanter (P <0.001). A trend toward a decrease in the incidence of vertebral fracture was observed in the 5-mg risedronate group compared with the placebo group (5.7{\%} versus 17.3{\%}; P = 0.072). Risedronate was well tolerated, and the incidence of upper gastrointestinal adverse events was comparable among the 3 groups. Conclusion. Risedronate therapy prevents bone loss in patients initiating long-term corticosteroid treatment.",
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T2 - A twelve- month, multicenter, randomized, double-blind, placebo-controlled, parallel- group study

AU - Cohen, Stanley

AU - Levy, Robert M.

AU - Keller, Michael

AU - Boling, Eugene

AU - Emkey, Ronald D.

AU - Greenwald, Maria

AU - Zizic, Thomas M.

AU - Wallach, Stanley

AU - Sewell, Kathryn L.

AU - Lukert, Barbara P.

AU - Axelrod, Douglas W.

AU - Chines, Arkadi A.

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