Hip Fracture Risk Up With Drug Holiday From Risedronate Versus Alendronate

After three or more years of therapy, drug holidays from risedronate versus alendronate linked to 18 percent increase in hip fracture risk

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THURSDAY, Jan. 13, 2022 (HealthDay News) -- Drug holidays after long-term risedronate are associated with a small increase in the risk for hip fracture compared with drug holidays after long-term alendronate, according to a study published online Jan. 11 in the Annals of Internal Medicine.

Kaleen N. Hayes, Pharm.D., Ph.D., from the Brown University School of Public Health in Providence, Rhode Island, and colleagues conducted a population-based, matched, cohort study to examine the comparative risks for fracture during a drug holiday after long-term (three or more years) risedronate versus alendronate therapy among persons aged 66 years or older. Data were included for 25,077 propensity score-matched pairs (mean age, 81 years; 81 percent women).

The researchers found that the rates of hip fracture were higher among risedronate versus alendronate drug holidays (12.4 versus 10.6 events per 1,000 patient-years; hazard ratio, 1.18; 95 percent confidence interval, 1.04 to 1.34). When any fracture was included as the outcome (hazard ratio, 1.07; 95 percent confidence interval, 1.00 to 1.16) and with shorter drug holidays (one year: hazard ratio, 1.03 [95 percent confidence interval, 0.85 to 1.24]; two years: hazard ratio, 1.14 [95 percent confidence interval, 0.96 to 1.32]), the association was attenuated.

"We emphasize that our results do not indicate that alendronate therapy should be preferred over risedronate therapy," the authors write. "The decision to initiate alendronate or risedronate therapy is driven by the prescriber and may be influenced by many patient-specific considerations."

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