Alendronate Might Help Protect Against Hip Fracture in Patients Taking Prednisolone

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

Use of alendronate is associated with lower hip fracture risk in older adults taking prednisolone, according to a retrospective cohort study in JAMA. The finding extends previous research showing that alendronate lowers risk for vertebral fracture in glucocorticoid users.

Using Swedish national registry data, researchers matched 1800 older adults (roughly 70% women) who were taking long-term oral prednisolone (5 mg /daily or more) and were prescribed alendronate to 1800 prednisolone users who did not receive alendronate. During roughly 1.3 years' follow-up, the hip fracture rate was 9.5 per 1000 person-years with alendronate versus 27.2 per 1000 without alendronate. After multivariable adjustment, hip fracture risk was significantly lower with alendronate.

The researchers estimate that the 30-month absolute risk reduction with alendronate was 4.1%. They conclude, "Although the findings are limited by the observational study design and the small number of events, these results support the use of alendronate in this patient group."