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Etidronate for treating and preventing postmenopausal osteoporosis
A Cranney1, V Welch, J D Adachi
1Medicine - Rheumatology, Ottawa Hospital, Civic Campus, 461, 737 Parkdale Ave, Ottawa, Ontario, Canada, K1Y 1J8. acranney@ottawahospital.on.ca
The Cochrane Database of Systematic Reviews
|November 1, 2001
Summary
Etidronate effectively increases bone density in postmenopausal women, particularly in the lumbar spine and femoral neck. While it reduces vertebral fractures, it shows no significant impact on non-vertebral fractures.
Area of Science:
- Bone Metabolism and Osteoporosis Research
- Pharmacological Interventions for Bone Health
- Geriatric Medicine and Postmenopausal Health
Background:
- Osteoporosis is a significant health concern for postmenopausal women, increasing fracture risk.
- Bisphosphonates, such as etidronate, are commonly used to manage bone loss.
- Understanding the long-term efficacy and safety of etidronate is crucial for clinical practice.
Purpose of the Study:
- To systematically review the efficacy of etidronate in improving bone density.
- To assess the impact of etidronate on fracture incidence in postmenopausal women.
- To evaluate the toxicity profile associated with etidronate treatment.
Main Methods:
- A comprehensive literature search was conducted across databases (MEDLINE) and conference proceedings.
- Inclusion criteria focused on randomized controlled trials of etidronate versus placebo or calcium/vitamin D, with bone density measurements.
- Thirteen trials involving 1010 participants were included, with data abstracted and quality assessed by independent reviewers.
Main Results:
- Etidronate significantly increased bone density: lumbar spine by 4.27%, femoral neck by 2.19%, and total body by 0.97% after three years.
- A reduction in vertebral fractures was observed (pooled relative risk 0.60).
- No significant effect was found on non-vertebral fractures (pooled relative risk 1.00).
Conclusions:
- Etidronate demonstrates efficacy in increasing bone mineral density at key skeletal sites.
- The drug is associated with a reduced risk of vertebral fractures.
- Current evidence does not support a benefit for etidronate in preventing non-vertebral fractures.