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Glucocorticoids are associated with a dose-dependent increased risk of hip fractures, but there is not sufficient evidence to show whether the osteoporosis treatment alendronate can reduce this.
In a retrospective cohort study, researchers analysed Swedish data on 1,802 patients aged 65 years and over who received a prescription for alendronate while receiving prednisolone for at least three months, compared with 1,802 matched controls who received similar prednisolone treatment courses without alendronate.
After median follow-up of 1.32 years, there were 27 hip fractures in the alendronate group compared with 73 in the prednisolone-only group. In multivariate analysis, this equated to a 65% reduced risk of hip fracture with alendronate.
Reporting in the Journal of the American Medical Association (online, 11 July 2017), the team says the findings support the use of alendronate in elderly patients receiving medium to high doses of prednisolone, but they are limited by the small number of events and observational study design[1]
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References
[1] Axelsson K, Nilsson A, Wedel H et al. Association between alendronate use and hip fracture risk in older patients using oral prednisolone. JAMA 2017;318:146–155. doi: 10.1001/jama.2017.8040
