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Relationship between changes in bone mineral density and vertebral fracture risk associated with risedronate: greater increases in bone mineral density do not relate to greater decreases in fracture risk

Watts, Nelson B., Cooper, Cyrus, Lindsay, Robert, Eastell, Richard, Manhart, Michael D., Barton, Ian P., van Staa, Tjeerd-Pieter and Adachi, Jonathan D. (2004) Relationship between changes in bone mineral density and vertebral fracture risk associated with risedronate: greater increases in bone mineral density do not relate to greater decreases in fracture risk Journal of Clinical Densitometry, 7, (3), pp. 255-261.

Record type: Article

Abstract

Low bone mineral density (BMD) is correlated with increased fracture risk. Whether greater BMD increases induced by osteoporosis drugs are related to greater decreases in fracture risk is controversial. We analyzed the relationship between BMD change and fracture risk in postmenopausal osteoporotic women receiving antiresorptive treatment. The analysis combined data from three pivotal risedronate fracture end-point trials. Women received risedronate (n = 2047) or placebo (n = 1177) daily for up to 3 yr. The BMD and vertebral radiographs were assessed periodically during 3 yr. The estimated risk of new vertebral fracture was compared between patients whose BMD increased and those whose BMD decreased. Risedronate-treated patients whose BMD decreased were at a significantly greater risk (p = 0.003) of sustaining a vertebral fracture than patients whose BMD increased. The fracture risk was similar (about 10%) in risedronate-treated patients whose increases in BMD were < 5% (the median change from baseline) and in those whose increases were ? 5% (p = 0.453). The changes in lumbar spine BMD explained only 18% (95% confidence interval [CI], 10%, 26%; p < 0.001) of risedronate's vertebral fracture efficacy. Although patients showing an increase in BMD had a lower fracture risk than patients showing a decrease in BMD, greater increases in BMD did not necessarily predict greater decreases in fracture risk.

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More information

Published date: 2004
Keywords: bone mineral density, vertebral fractures, risedronate, surrogate measure, osteoporosis, antiresorptive therapy

Identifiers

Local EPrints ID: 26116
URI: http://eprints.soton.ac.uk/id/eprint/26116
ISSN: 1094-6950
PURE UUID: d7768828-28af-4992-8564-c22583798e6c
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709

Catalogue record

Date deposited: 12 Apr 2006
Last modified: 17 Jul 2017 16:08

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Contributors

Author: Nelson B. Watts
Author: Cyrus Cooper ORCID iD
Author: Robert Lindsay
Author: Richard Eastell
Author: Michael D. Manhart
Author: Ian P. Barton
Author: Tjeerd-Pieter van Staa
Author: Jonathan D. Adachi

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