Journal of Bone and Mineral Metabolism

, Volume 29, Issue 1, pp 88–95 | Cite as

Risedronate improves proximal femur bone density and geometry in patients with osteoporosis or osteopenia and clinical risk factors of fractures: a practice-based observational study

  • Masayuki Takakuwa
  • Jun Iwamoto
  • Masahisa Konishi
  • Qi Zhou
  • Koichi Itabashi
Original Article

Abstract

The purpose of this practice-based observational study was to clarify the acute effect of risedronate on proximal femur bone mineral density (BMD) and structural geometry in patients with an increased risk of fractures. One hundred sixty-four patients (7 men and 157 postmenopausal women; mean age, 69.2 years) with osteoporosis or osteopenia and clinical risk factors of fractures were analyzed. All these patients were treated with risedronate for 1 year. Urinary levels of cross-linked N-terminal telopeptide of type I collagen (NTX) were measured at baseline and 4 months after the start of treatment. BMD of the lumbar spine and proximal femur and structural geometric parameters of the proximal femur were evaluated by dual-energy X-ray absorptiometry with advanced hip assessment (AHA) software at baseline and every 4 months. Urinary NTX levels significantly decreased after 4 months of treatment. BMD of the femoral neck and total hip significantly increased after 4, 8, and 12 months of treatment. Cross-sectional moment of inertia (CSMI) and cross-sectional area significantly increased after 4, 8, and 12 months of treatment. An increase in CSMI was apparently greater than those of proximal femur BMD after 4 months of treatment. These results suggest the acute (4 months) and sustained (12 months) effect of risedronate on proximal femur structural geometry as well as BMD as a result of suppression of bone resorption in patients with an increased risk of fractures.

Keywords

Risedronate Geometry Bone mineral density Advanced hip assessment Femoral neck 

Notes

Acknowledgments

We have no funding sources.

Conflict of interest statement

We have no conflict of interest

References

  1. 1.
    Reginster J, Minne HW, Sorensen OH, Hooper M, Roux C, Brandi ML, Lund B, Ethgen D, Pack S, Roumagnac I, Eastell R (2000) Randomized trial of the effects of risedronate on vertebral fractures in women with established postmenopausal osteoporosis. Vertebral Efficacy with Risedronate Therapy (VERT) Study Group. Osteoporos Int 11:83–91CrossRefPubMedGoogle Scholar
  2. 2.
    Harris ST, Watts NB, Genant HK, McKeever CD, Hangartner T, Keller M, Chesnut CH 3rd, Brown J, Eriksen EF, Hoseyni MS, Axelrod DW, Miller PD (1999) Effects of risedronate treatment on vertebral and nonvertebral fractures in women with postmenopausal osteoporosis: a randomized controlled trial. Vertebral Efficacy with Risedronate Therapy (VERT) Study Group. JAMA 282:1344–1352CrossRefPubMedGoogle Scholar
  3. 3.
    McClung MR, Geusens P, Miller PD, Zippel H, Bensen WG, Roux C, Adami S, Fogelman I, Diamond T, Eastell R, Meunier PJ, Reginster JY (2001) Effect of risedronate on the risk of hip fracture in elderly women. Hip Intervention Program Study Group. N Engl J Med 344:333–340CrossRefPubMedGoogle Scholar
  4. 4.
    Wells G, Cranney A, Peterson J, Boucher M, Shea B, Robinson V, Coyle D, Tugwell P (2008) Risedronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women. Cochrane Database Syst Rev 23:CD004523Google Scholar
  5. 5.
    Zhong ZM, Chen JT (2009) Anti-fracture efficacy of risedronic acid in men: a meta-analysis of randomized controlled trials. Clin Drug Invest 29:349–357CrossRefGoogle Scholar
  6. 6.
    Roux C, Seeman E, Eastell R, Adachi J, Jackson RD, Felsenberg D, Songcharoen S, Rizzoli R, Di Munno O, Horlait S, Valent D, Watts NB (2004) Efficacy of risedronate on clinical vertebral fractures within 6 months. Curr Med Res Opin 20:433–439CrossRefPubMedGoogle Scholar
  7. 7.
    Harrington JT, Ste-Marie LG, Brandi ML, Civitelli R, Fardellone P, Grauer A, Barton I, Boonen S (2004) Risedronate rapidly reduces the risk for nonvertebral fractures in women with postmenopausal osteoporosis. Calcif Tissue Int 74:129–135CrossRefPubMedGoogle Scholar
  8. 8.
    Dunford JE, Thompson K, Coxon FP, Luckman SP, Hahn FM, Poulter CD, Ebetino FH, Rogers MJ (2001) Structure-activity relationships for inhibition of farnesyl diphosphate synthase in vitro and inhibition of bone resorption in vivo by nitrogen-containing bisphosphonates. J Pharmacol Exp Ther 296:235–342PubMedGoogle Scholar
  9. 9.
    NIH Consensus Development Panel (2001) Osteoporosis prevention, diagnosis, and therapy. JAMA 285:785–795CrossRefGoogle Scholar
  10. 10.
    Yoshikawa T, Turner CH, Peacock M, Slemenda CW, Weaver CM, Teegarden D, Markwardt P, Burr DB (1994) Geometric structure of the femoral neck measured using dual-energy-X-ray absorptiometry. J Bone Miner Res 9:1053–1064CrossRefPubMedGoogle Scholar
  11. 11.
    Shiraki M, Fukunaga M, Kushida K, Kishimoto H, Taketani Y, Minaguchi H, Inoue T, Morita R, Morii H, Yamamoto K, Ohashi Y, Orimo H (2003) A double-blind dose-ranging study of risedronate in Japanese patients with osteoporosis (a study by the Risedronate Late Phase II Research Group). Osteoporos Int 14:225–234PubMedGoogle Scholar
  12. 12.
    Orimo H, Sugioka Y, Fukunaga M, Muto Y, Hotokebuchi T, Gorai I, Nakamura T, Kushida K, Tanaka H, Ikai T, Oh-hashi Y (1998) Diagnostic criteria of primary osteoporosis. J Bone Miner Metab 16:139–150CrossRefGoogle Scholar
  13. 13.
    Orimo H, Hayashi Y, Fukunaga M, Sone T, Fujiwara S, Shiraki M, Kushida K, Miyamoto S, Soen S, Nishimura J, Oh-Hashi Y, Hosoi T, Gorai I, Tanaka H, Igai T, Kishimoto H, Osteoporosis Diagnostic Criteria Review Committee, Japanese Society for Bone Mineral Research (2001) Diagnostic criteria for primary osteoporosis: year 2000 revision. J Bone Miner Metab 19:331–337CrossRefPubMedGoogle Scholar
  14. 14.
    Orimo H (2006) Japanese guideline for prevention and treatment of osteoporosis. Life Science, Tokyo (in Japanese)Google Scholar
  15. 15.
    Fukunaga M, Kushida K, Kishimoto H, Shiraki M, Taketani Y, Minaguchi H, Inoue T, Morita R, Morii H, Yamamoto K, Ohashi Y, Orimo H (2002) A comparison of the effect of risedronate and etidronate on lumbar bone mineral density in Japanese patients with osteoporosis: a randomized controlled trial. Osteoporos Int 13:971–979CrossRefPubMedGoogle Scholar
  16. 16.
    Kishimoto H, Fukunaga M, Kushida K, Shiraki M, Itabashi A, Nawata H, Nakamura T, Ohta H, Takaoka K, Ohashi Y (2006) Efficacy and tolerability of once-weekly administration of 17.5 mg risedronate in Japanese patients with involutional osteoporosis: a comparison with 2.5-mg once-daily dosage regimen. J Bone Miner Metab 24:405–413CrossRefPubMedGoogle Scholar
  17. 17.
    Beck TJ, Looker AC, Ruff CB, Sievanen H, Wahner HW (2000) Structural trends in the aging femoral neck and proximal shaft; analysis of the third national health and nutrition examination survey dual-energy X-ray absorptiometry data. J Bone Miner Res 15:2297–2304CrossRefPubMedGoogle Scholar
  18. 18.
    Melton LJ III, Beck TJ, Amin S, Khosla S, Achenbach SJ, Oberg AL, Riggs BL (2005) Contributions of bone density and structure to fracture risk assessment in men and women. Osteoporos Int 16:460–467CrossRefPubMedGoogle Scholar
  19. 19.
    Takada J, Beck TJ, Iba K, Yamashita T (2007) Structural trends in the aging proximal femur in Japanese postmenopausal women. Bone (NY) 41:97–102Google Scholar
  20. 20.
    Cheng X, Barden H, Brown JK, Zhou Q (2007) Comparison of femur structure measurements derived from DXA and QCT. J Bone Miner Res 22(suppl 1):S420Google Scholar
  21. 21.
    Muschitz C, Milassin L, Pirker T, Waneck R, Resch H (2007) DXA and QCT geometric structural measurements of proximal femoral strength. J Bone Miner Res 22(suppl 1):S303Google Scholar
  22. 22.
    Faulkner KG, Wacker WK, Barden HS, Simonelli C, Burke PK, Ragi S, Del Rio L (2006) Femur strength index predicts hip fracture independent of bone density and hip axis length. Osteoporosis Int 17:593–599CrossRefGoogle Scholar
  23. 23.
    Szulc P, Duboeuf F, Schott AM, Dargent-Molina P, Meunier PJ, Delmas PD (2006) Structural determinants of hip fracture in elderly women: re-analysis of the data from the EPIDOS study. Osteoporos Int 17:231–236CrossRefPubMedGoogle Scholar
  24. 24.
    Mautalen CA, Vega EM, Einhorn TA (1996) Are the etiologies of cervical and trochanteric hip fractures different? Bone (NY) 18 (suppl):S133–S137Google Scholar
  25. 25.
    Greenspan SL, Beck TJ, Resnick NM, Bhattacharya R, Parker RA (2005) Effect of hormone replacement, alendronate, or combination therapy on hip structural geometry: a 3-year, double blind, placebo controlled clinical trial. J Bone Miner Res 20:1525–1532CrossRefPubMedGoogle Scholar
  26. 26.
    Bonnick SL, Beck TJ, Cosman F, Hochberg MC, Wang H, de Papp AE (2009) DXA-based hip structural analysis of once-weekly bisphosphonate-treated postmenopausal women with low bone mass. Osteoporos Int 20:911–921CrossRefPubMedGoogle Scholar
  27. 27.
    van Londen GJ, Perera S, Vujevich KT, Sereika SM, Bhattacharya R, Greenspan SL (2008) Effect of risedronate on hip structural geometry: a 1-year, double-blind trial in chemotherapy-induced postmenopausal women. Bone (NY) 43:274–278Google Scholar
  28. 28.
    Iwamoto J, Sato Y, Takeda T, Matsumoto H (2008) Hip fracture protection by alendronate treatment in postmenopausal women with osteoporosis: a review of the literature. Clin Interv Aging 3:483–489PubMedGoogle Scholar

Copyright information

© The Japanese Society for Bone and Mineral Research and Springer 2010

Authors and Affiliations

  • Masayuki Takakuwa
    • 1
  • Jun Iwamoto
    • 2
  • Masahisa Konishi
    • 3
  • Qi Zhou
    • 4
  • Koichi Itabashi
    • 5
  1. 1.Takakuwa Orthopaedic Nagayama ClinicHokkaidoJapan
  2. 2.Institute for Integrated Sports MedicineKeio University School of MedicineTokyoJapan
  3. 3.GE HealthcareTokyoJapan
  4. 4.GE HealthcareShanghaiChina
  5. 5.Eisai Co., Ltd.TokyoJapan

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