Do Bisphosphonates Prevent Hip Fractures in Glucocorticoid Users?

Bisphosphonate drugs are recommended to prevent glucocorticoid-related fractures. Because the specific effect of these drugs on hip fracture incidence in steroid-treated patients is unclear, Swedish investigators conducted this retrospective study using a registry of older patients (age, ≥65) called “Senior Alert.” Nearly all of these patients were enrolled during hospitalizations or were nursing home residents. Among patients in this database, 1802 took ≥5 mg of prednisolone daily for at least 3 months and started the bisphosphonate alendronate shortly after beginning steroid therapy; these patients were propensity-matched with 1802 patients who took prednisolone but no osteoporosis drug. About half the patients had diagnoses of either pol…