September 20th, 2016

By Frances Morin

ATLANTA -- September 20, 2016 -- Treatment with the osteoporosis drug alendronate is effective in reducing the risk of hip fracture in patients aged older than 80 years who have sustained a prior fracture, according to a study presented here at the 2016 Annual Meeting of the American Society for Bone and Mineral Research (ASBMR).

“We conclude that alendronate treatment was associated with reduced hip fracture risk in the oldest old and that the number needed to treat in these groups was substantially lower than in the younger age groups,” wrote Mattias Lorentzon, MD, University of Gothenburg, Gothenburg, Sweden, and colleagues in their presentation.

Alendronate has been shown to effectively reduce the risk of hip fracture in patients with prior fractures; however, evidence is less clear on its efficacy in patients aged older than 80 years -- when fracture risk is highest.

To investigate, the researchers evaluated data on 110,190 patients from Sweden with a mean age of 82 years (65% women) who had suffered a prior fracture and been assessed between 2008 and 2014.

The review included information on prevalent and incident medication, diseases, fractures, and deaths. The follow-up period extended from the first assessment until death, emigration or the end of the study period.

After adjusting for factors including age, sex, weight, height, previous medication, secondary osteoporosis, Charlson comorbidity, and exposition time, use of alendronate was associated with a statistically significant reduction in the risk for hip fracture (hazard ratio [HR] = 0.72; P < .001).

The risk reduction was prevalent across all age quartiles; however, an estimated absolute risk reduction after 5 years was found to increase substantially according to quartile of age.

There were no significant increases in adverse events, including esophagitis, dyspepsia, and acid reflux associated with exposure to alendronate.

“These results suggest that alendronate treatment in the oldest old is effective and safe, and should be prioritised in order to reduce the high fracture rates in this age group,” the authors concluded.

[Presentation title: Alendronate Treatment Is Associated With Reduced Fracture Risk and Maintained Safety in the Oldest Old. Abstract 1006]