Arthritis News – 1999

Bone loss due to reduced bone formation and increased bone resorption is a common result of long term corticosteroid therapy. Chines etal (Arthritis & Rheumatism 42:2309, 1999), in a 12-month, randomized, placebo-controlled, double-blind, multicenter trial, examined the safety and efficacy of risedronate as a preventative therapy for corticosteroid-induced bone loss.

Patients were randomized to one of three treatment groups: placebo (n=57) or 2.5 mg risedronate (n=31) or 5 mg risedronate (n=62). All patients, at baseline, were receiving long-term corticosteroid treatment (mean dose 11 mg daily) and calcium 500 mg daily. The primary endpoint was bone mineral density (BMD) of the lumbar spine. Lumbar spine BMD comparisons done at baseline and after 12 months of therapy showed no significant changes in the 5 mg risedronate group (0.6 + 0.5%) or in the 2.5 mg risedronate group (-0.1 + 0.7%) but showed a decrease in the placebo group (-2.8 + 0.5%). The incidence of vertebral fractures was 5.7% in the 5 mg risedronate group compared to 17.3% in the placebo group. Adverse events, including back pain, arthralgia, and upper GI events, were comparable for all three treatment groups.

The conclusion from this study is that bone loss in patients beginning long-term corticosteroid treatment can be significantly reduced, and possibly prevented, with concomitant risedronate therapy.