Document Detail

Can fall risk be incorporated into fracture risk assessment algorithms: a pilot study of responsiveness to clodronate.
MedLine Citation:
PMID:  19436939     Owner:  NLM     Status:  MEDLINE    
SUMMARY: Fall risk does not significantly impact on the efficacy of the bisphosphonate clodronate in reducing the incidence of fracture.
INTRODUCTION: The debate about the efficacy of skeletal therapies on fracture risk in women at increased risk of falling continues. We determined whether fall risk impeded the efficacy of clodronate to reduce osteoporotic fracture incidence.
METHODS: This is a post hoc analysis of a 3-year placebo-controlled study of bisphosphonate clodronate involving 5,212 women aged 75 years or more. At entry, self-reported multiple falls in the previous month and ability to rise from a chair were documented. Their interaction with treatment efficacy was examined using Poisson regression.
RESULTS: Oral doses of clodronate at 800 mg daily reduced osteoporotic fracture incidence by 24% (hazard ration (HR) 0.76, 95% confidence interval 0.63-0.93). The efficacy was similar in women with recent multiple falls compared to those without (HR 0.61 vs. 0.77, p value for interaction >0.30) or impaired ability in rising compared to those with no impairment (HR 0.79 vs. 0.74, respectively; p value > 0.30).
CONCLUSION: Fall risk does not significantly impact on the anti-fracture efficacy of clodronate. If confirmed with other agents, fall risk may be incorporated into risk assessment tools designed to target skeletal therapies.
K Kayan; H Johansson; A Oden; S Vasireddy; K Pande; J Orgee; J A Kanis; E V McCloskey
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2009-05-13
Journal Detail:
Title:  Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA     Volume:  20     ISSN:  1433-2965     ISO Abbreviation:  Osteoporos Int     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2010-03-10     Completed Date:  2011-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9100105     Medline TA:  Osteoporos Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  2055-61     Citation Subset:  IM    
WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK.
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MeSH Terms
Accidental Falls*
Aged, 80 and over
Bone Density / physiology
Bone Density Conservation Agents / therapeutic use*
Clodronic Acid / therapeutic use*
Epidemiologic Methods
Femur Neck / physiopathology
Osteoporosis, Postmenopausal / complications,  physiopathology
Osteoporotic Fractures / etiology,  physiopathology,  prevention & control*
Treatment Outcome
Grant Support
//Medical Research Council
Reg. No./Substance:
0/Bone Density Conservation Agents; 10596-23-3/Clodronic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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