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Most Osteoporosis Drugs Prevent Fractures Equally

Only nasal calcitonin is linked to an increased risk of non-vertebral fractures

TUESDAY, May 6 (HealthDay News) -- Among patients who receive drug treatment for osteoporosis, the risk of non-vertebral fracture is not significantly different between those assigned to risedronate or raloxifene, or between those assigned to risedronate or alendronate. But nasal calcitonin recipients may be at greater risk for non-vertebral fractures than alendronate recipients, according to the results of a study published in the May 6 issue of the Annals of Internal Medicine.

Suzanne M. Cadarette, Ph.D., of Brigham and Women's Hospital and the Harvard Medical School in Boston, and colleagues compared outcomes in 41,135 new recipients (mean age 79, 96 percent female) of oral bisphosphonates, nasal calcitonin and raloxifene, who started treatment between 2000 and 2005.

The researchers found that 1,051 non-vertebral fractures occurred within 12 months of treatment initiation and that there were no significant differences in fracture risk when they compared risedronate versus raloxifene and risedronate versus alendronate. When they assessed risk in patients with a fracture history, however, they observed more non-vertebral fractures in raloxifene recipients than in alendronate recipients (hazard ratio, 1.78). They also observed more non-vertebral fractures in calcitonin recipients compared to alendronate recipients (HR, 1.4).

"Although we found a 40 percent higher risk for non-vertebral fractures among nasal calcitonin recipients than alendronate recipients, future studies that can better adjust for potential residual confounding may clarify our results," the authors conclude.

Two of the study authors disclose financial relationships with the pharmaceutical industry.

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