Table 57RCTs of bisphosphonates used to treat or prevent glucocorticoid-induced osteoporosis that report fracture data included in prior systematic review*

Author, yearBisphosphonateControlNMean daily steroid dosePopulationResults
Studies included in systematic review
Adachi, 1997274 Cyclical etidronate: 400 mg/d X 2weeks, then 500 mg/d Ca X 11 weeks; could use 1000 u/d vit DCyclical placebo, then 500 mg/d Ca; could use 1000 u/d vitamin D11711 mg prednisonePrimary; 42 men/75 womenTrend toward reduced fracture risk for etidronate.
Mean age 58 years with primarily RA, PMR
Cohen, 1999137 Risedronate 2.5 or 5 mg/d + 1000mg/d Ca + 400 u/d vit DPlacebo + 1000 mg/d Ca + 400u/d vit D29015 mg prednisoneSecondary, men and womenTrend toward reduced fracture risk for risedronate.
Mean age 58.4, primarily RA, PMR
Cortet, 1999281 Cyclical etidronate 400 mg/d X 2 weeks then 500 mg/d Ca X 11 weeks500 mg/d Ca12NrPrimary, 3 men/ 9 women (33% postmenopausal) with primary biliary cirrhosisFractures reported but not analyzed.
Geusens, 1998280 Cyclical etidronate 400 mg/d X 2 weeks then 500 mg/d Ca X 11 weeks; could use 1000 u/d vit DCyclical placebo, then 500 mg/d Ca; could use 1000 u/d vitamin D8312.5 mg prednisonePrimary, 28 men/ 55 women (84% postmenopausal) with primary RA and PMRNo significant difference in fracture rate but not powered to detect.
Jenkins, 1999279 Cyclical etidronate 400 mg/d X 2 weeks then 97 mg/d Ca + 400 u/d vit D X 11 weeksCyclical placebo then 97 mg/d Ca + 400400 u/d vit D497.5 mg prednisoloneSecondary 19 men/ 30 women, mean age 59 years, with asthma, PMR, and SLEFractures reported but not analyzed.
Jensen, 1998277 Risedronate1000 mg/d Ca558.5 mg prednisoneUnknown combination 11 men/ 44 women (mean age 64) with primarily PMR, TA, asthmaSignificant reduction in fracture risk for risedronate relative to placebo.
Roux, 1998275 Clodronate 800, 1600, or 2400 mg/dPlacebo748 mg prednisoloneSecondary 33 men/ 41 women (73% postmenopausal) age range 39–73, with asthma or COPDNo significant difference in fracture rate but not powered to detect.
Saag, 1998276 Risedronate 2.5, 5, or 10 mg/d + 500 mg/d CaPlacebo + 500 mg/d Ca47721 mg prednisonePrimary 477 men and women (70% postmenopausal) mean age 59.4±14.3, primarily RA, PMR, SLETrend toward reduced fracture risk for risedronate.
Skingle, 1999278 Cyclical etidronate 400 mg/d X 2 wks then 500 mg/d Ca 11 wksCyclical placebo then 500 mg/d Ca289 mg/d prednisolonePrimary 11 men/ 17 women with PMR or RAFractures reported but not analyzed.
Studies published after systematic review
Adachi, 2001272 Alendronate 5 or 10 mg X 24 mos (or 2.5 mg for 12 mos and 10 mg for 12 mos) + 800–1000 mg/d Ca + 250–500 u/d vit DPlacebo + 800–1000 mg/d Ca + 250–500 u/d vit D2087.5 mg prednisone (10 mg in year 2)66 men/ 142 women (63% postmenopausal), age range 21–7990% reduction in vertebral fractures (2 years); 70% reduction in nonvertebral fractures.
Reid, 2000136 Risedronate 2.5 or 5 mg/d + 1g/d Ca + 400 u/d vit D X 12 mosPlacebo + 1g/d Ca + 400 u/d vit D290≥7.5 mg prednisoneAmbulatory men and women, age 18–85, primarily RA, dermatologic, respiratory diseases70% reduction in vertebral fractures.
Wallach, 2000273 Risedronate 2.5 or 5 mg/d + 1000 mg/d Ca + 400 u/d vit D X 12 mosPlacebo + 1000 mg/d Ca + 400 u/d vit D5097.5 mg prednisone equivalent184 Men/ 325 women (78% postmenopausal), age range 18–85 years, primarily RA, PMR, TA, CILD, COPD, asthma, and others2.5 mg risedronate: 58% reduction in vertebral fractures; 5 mg risedronate: 70% reduction in vertebral fractures.
*

Systematic review by Blair et al., 2000271;

CILD Chronic infiltrative lung disease, COPD chronic obstructive pulmonary disease, PMR polymyalgia rheumatica, RA rheumatoid arthritis, SLE Systemic Lupus Erythematosus

From: 3, Results

Cover of Comparative Effectiveness of Treatments To Prevent Fractures in Men and Women With Low Bone Density or Osteoporosis
Comparative Effectiveness of Treatments To Prevent Fractures in Men and Women With Low Bone Density or Osteoporosis [Internet].
Comparative Effectiveness Reviews, No. 12.
MacLean C, Alexander A, Carter J, et al.

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