Risedronate improves bone mineral density in Crohn's disease: a two year randomized controlled clinical trial

Area of Science:

• Gastroenterology
• Endocrinology
• Rheumatology

Background:

• Crohn's disease is associated with increased rates of osteopenia and osteoporosis.
• Low bone mineral density (BMD) is a significant concern for patients with Crohn's disease.

Purpose of the Study:

• To evaluate the efficacy of risedronate compared to placebo in treating low BMD in Crohn's disease patients.
• To assess the impact of risedronate on bone mineral density at various skeletal sites.

Main Methods:

• A randomized, double-blind, placebo-controlled study involving 88 Crohn's disease outpatients with low BMD (T-score < -1.0).
• Participants received either 35 mg of risedronate weekly or a placebo, alongside daily calcium (500 mg) and vitamin D (400 IU) supplementation for two years.
• Bone mineral density changes were measured using dual-energy X-ray absorptiometry at 12 and 24 months.

Main Results:

• Risedronate significantly increased BMD at the femoral trochanter and total hip compared to placebo after 12 and 24 months.
• No significant difference in spine BMD changes was observed between the risedronate and placebo groups.
• Subgroup analyses indicated greater BMD improvement with risedronate in non-smokers, males, and patients with a history of corticosteroid use or current immunosuppressant use.

Conclusions:

• Risedronate, combined with calcium and vitamin D, demonstrates superiority over calcium and vitamin D alone for enhancing femoral trochanter and total hip BMD in Crohn's disease patients.
• The findings support the use of risedronate as a therapeutic option for managing low bone mineral density in this patient population.