Monthly Risedronate for the Treatment of Postmenopausal Osteoporosis

Jun Iwamoto

doi:10.4172/2153-2435.1000285

Abstract

Risedronate is a first-line medicine for the treatment of postmenopausal osteoporosis, since meta-analyses of large randomized controlled trials have demonstrated its efficacy against vertebral, nonvertebral, and hip fractures. Risedronate has desirable pharmacological characteristics in terms of its low affinity for bone, and its strong inhibition of farnesyl pyrophosphate synthase rapidly reduces bone turnoverand reverses the effect. Monthly risedronate, which has been recently approved, is non-inferior to daily risedronate in terms of changes in surrogate markers and the incidence of adverse effects. However, the incidence of acute phase reactions is higher for a monthly dosing regimen than for a daily dosing regimen. Because monthly bisphosphonates are superior to weekly bisphosphonates in terms of patient preference and convenience and, consequently, treatment adherence (particularly persistence), monthly risedronate is considered to be useful in clinical practice

Highlights

Osteoporosis mostly affects postmenopausal women and substantially increases their risk of fracture
Risedronate is a first-line medicine for the treatment of postmenopausal osteoporosis, since meta-analyses of large randomized controlled trials (RCTs) have demonstrated its efficacy against vertebral, nonvertebral, and hip fractures [2,3]
The present review discusses the key characteristics of risedronate, three major Adverse Effects (AEs) of monthly bisphosphonates, Osteonecrosis of the Jaw (ONJ), Atypical Femoral Fractures (AFFs), and Acute-phase Reactions (APRs), and the clinical outcome of monthly risedronate in patients with postmenopausal osteoporosis

Summary

Introduction

Osteoporosis mostly affects postmenopausal women and substantially increases their risk of fracture. It is important to prevent fragility fractures in patients with postmenopausal osteoporosis. The ideal osteoporosis treatment is a drug therapy with the efficacy against vertebral, nonvertebral, and hip fractures, good tolerability, good patient adherence, and low cost. Bisphosphonates normalize bone turnover and increase bone mineral density (BMD), thereby preventing fragility fractures [1]. Risedronate is a first-line medicine for the treatment of postmenopausal osteoporosis, since meta-analyses of large randomized controlled trials (RCTs) have demonstrated its efficacy against vertebral, nonvertebral, and hip fractures [2,3]. The present review discusses the key characteristics of risedronate, three major Adverse Effects (AEs) of monthly bisphosphonates, Osteonecrosis of the Jaw (ONJ), Atypical Femoral Fractures (AFFs), and Acute-phase Reactions (APRs), and the clinical outcome of monthly risedronate in patients with postmenopausal osteoporosis

Key Characteristics of Risedronate

Major AEs of Monthly Bisphosphonates

Monthly Risedronate

Findings

Conclusions