Etidronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women

In postmenopausal women with osteoporosis etidronate appears to reduce vertebral fractures, but it may not be effective when used for primary prevention. It may not prevent non-vertebral, hip of wrist fractures.

A Cochrane review included 11 studies with a total of 1 248 subjects. Etidronate did not reduce non-vertebral, hip or wrist fractures. A significant 41% relative risk reduction (RRR) in vertebral fractures (RR 0.59, 95% CI 0.36 to 0.96; 8 studies, n=1010) was found. The six secondary prevention trials demonstrated a significant RRR of 47% in vertebral fractures (RR 0.53, 95% CI 0.32 to 0.87; n=695) and a 5% absolute risk reduction; compared with the pooled result for the two primary prevention trials (RR 3.03, 95% CI 0.32 to 28.44; n=315), which was not significant.

For adverse events, no statistically significant differences were found in the included studies. However, observational data has led to concerns regarding potential risk for upper gastrointestinal injury.

Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment and more than 20% loss to follow up).

Ədəbiyyat

1. Wells GA, Cranney A, Peterson J, Boucher M, Shea B, Robinson V, Coyle D, Tugwell P. Etidronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women. Cochrane Database Syst Rev 2008 Jan 23;(1):CD003376.