Analysis debunks age bias in bisphosphonate therapy for elderly.(Gynecology)

HARROGATE, ENGLAND -- Age and frailty should not deter physicians from offering very elderly osteoporotic patients antiresorptive therapy, despite age-associated increases in comorbid conditions, said Steven Boonen, M.D

The results of a pooled analysis from three randomized, double-blind controlled trials showed a significantly reduced risk of new vertebral fractures among 704 osteoporotic women aged 80 and older who received bisphosphonate therapy, compared with age and disease-matched patients randomized to placebo treatment, Dr. Boonen reported in a presentation at the annual conference of the National Osteoporosis Society.

"To the best of our knowledge, this study is the first to document a benefit of antiresorptive treatment in addition to that afforded by calcium and vitamin D in a population of women aged 80 and older with osteoporosis," said Dr. Boonen of Leuven (Belgium) University Center for Metabolic Bone Disease, the study's principal investigator. "The findings tell us that, even in the very old, reducing bone resorption rates remains an effective treatment strategy."

The studies each looked at 3-year fracture end points and included women aged 80-100 years with documented osteoporosis. In each study, the women randomized to bisphosphonate therapy were prescribed 5 mg / day of risedronate (Actonel) for up to 3 years, and control group patients were given a placebo pill for the same duration. Participants received 1,000 mg calcium supplementation per day and, if baseline levels were low, up to 500 U of vitamin D per day.

At 1 year, the risedronate groups had a new vertebral fracture rate of 2.5%, compared with 10.9% for the control groups. At 3 years, the new vertebral fracture rates for the bisphosphonate and placebo groups were 18.2% and 24.6%, respectively, "representing a 44% reduction in risk for the women who took rise-dronate," Dr. Boonen said.

The rates of nonvertebral fractures were ...