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Co-prescribe bisphosphonate with steroid to reduce hip fractures, says study

Prescribing alendronate to elderly patients taking oral prednisolone significantly reduces the number of hip fractures in this patient group, a study has found.

The retrospective cohort study found that patients aged over 65 who were taking oral prednisolone without alendronate, a drug commonly prescribed in osteoporosis to inhibit bone resorption, were at greater risk of hip fractures than those who were co-prescribed the two drugs.

The study, led by a team in Sweden, looked at records from just over 3,600 patients and found that after approximately 1.3 years of follow up, patients not taking alendronate had experienced 72 hip fractures, compared to just 27 in the alendronate group.

The team found that taking alendronate was associated with a significant 65% reduced risk of hip fracture. There was also no increased risk of upper gastrointestinal symptoms in patients taking alendronate and no cases of osteonecrosis – common concerns in patients on the drug.

The team said: ‘Among older patients using medium to high doses of prednisolone, alendronate treatment was associated with a significantly lower risk of hip fracture over a median of 1.32 years.

'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.’

JAMA 2017; available online July 11th 

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