PMID- 21365461
OWN - NLM
STAT- MEDLINE
DCOM- 20120321
LR  - 20220321
IS  - 1433-2965 (Electronic)
IS  - 0937-941X (Linking)
VI  - 23
IP  - 1
DP  - 2012 Jan
TI  - Vertebral fracture efficacy during risedronate therapy in patients using proton 
      pump inhibitors.
PG  - 277-84
LID - 10.1007/s00198-011-1574-5 [doi]
AB  - Recent evidence suggests that proton pump inhibitor (PPI) use may affect fracture 
      risk, an important issue for patients being concurrently treated for 
      osteoporosis. The results of our post hoc analysis showed that, regardless of PPI 
      concomitant use, risedronate significantly reduced the risk of new vertebral 
      fractures compared with placebo. INTRODUCTION: Recent evidence suggests that PPI 
      use may affect fracture risk, an important issue for patients being concurrently 
      treated for osteoporosis. Moreover, data suggest that concomitant use of PPIs may 
      wane the anti-fracture effect of bisphosphonates. We explored the relationship 
      between concomitant use of PPIs and incident vertebral fractures among patients 
      treated with risedronate or placebo. Bone mineral density (BMD) and upper 
      gastrointestinal (UGI) adverse events (AEs) were also assessed. METHODS: This 
      study is a post hoc analysis of a subset of patients participating in three 
      prospective, randomized, placebo-controlled clinical trials, with durations of up 
      to 3 years, which evaluated the efficacy of risedronate in reducing fracture 
      risk: Vertebral Efficacy with Risedronate Trial-MultiNational (VERT-MN); 
      Vertebral Efficacy with Risedronate Trial-North America (VERT-NA); and the 
      risedronate Hip Intervention Program (HIP). RESULTS: Total enrollment included 
      2,729 risedronate and 2,725 placebo patients. Concomitant acid-suppressing drugs 
      were used by 8.8% of the total population (n = 482). Regardless of PPI 
      concomitant use, risedronate significantly reduced the risk of new vertebral 
      fractures compared with placebo (risk reduction: PPI users 57%, p = 0.009; PPI 
      non-users 38%, p < 0.001). BMD increased with risedronate, independent of PPI 
      use. PPI users were at a 2.5-fold greater risk of experiencing at least one UGI 
      AE compared with non-users. CONCLUSIONS: Risedronate significantly reduced the 
      risk of new vertebral fractures compared with placebo, regardless of PPI 
      concomitant use.
FAU - Roux, C
AU  - Roux C
AD  - Department of Rheumatology, AP-HP Cochin Hospital, Paris Descartes University, 27 
      rue Faubourg Saint Jacques, Paris 75014, France. christian.roux@cch.aphp.fr
FAU - Goldstein, J L
AU  - Goldstein JL
FAU - Zhou, X
AU  - Zhou X
FAU - Klemes, A
AU  - Klemes A
FAU - Lindsay, R
AU  - Lindsay R
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20110302
PL  - England
TA  - Osteoporos Int
JT  - Osteoporosis international : a journal established as result of cooperation 
      between the European Foundation for Osteoporosis and the National Osteoporosis 
      Foundation of the USA
JID - 9100105
RN  - 0 (Bone Density Conservation Agents)
RN  - 0 (Proton Pump Inhibitors)
RN  - KM2Z91756Z (Risedronic Acid)
RN  - M2F465ROXU (Etidronic Acid)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Bone Density/drug effects
MH  - Bone Density Conservation Agents/adverse effects/*therapeutic use
MH  - Etidronic Acid/adverse effects/*analogs & derivatives/therapeutic use
MH  - Female
MH  - Femur Neck/physiopathology
MH  - Gastrointestinal Diseases/chemically induced
MH  - Humans
MH  - Lumbar Vertebrae/physiopathology
MH  - Middle Aged
MH  - Osteoporosis, Postmenopausal/complications/drug therapy/physiopathology
MH  - Osteoporotic Fractures/*prevention & control
MH  - Polypharmacy
MH  - Proton Pump Inhibitors/*adverse effects/pharmacology
MH  - Randomized Controlled Trials as Topic
MH  - Risedronic Acid
MH  - Spinal Fractures/etiology/*prevention & control
MH  - Treatment Outcome
EDAT- 2011/03/03 06:00
MHDA- 2012/03/22 06:00
CRDT- 2011/03/03 06:00
PHST- 2010/10/12 00:00 [received]
PHST- 2011/01/19 00:00 [accepted]
PHST- 2011/03/03 06:00 [entrez]
PHST- 2011/03/03 06:00 [pubmed]
PHST- 2012/03/22 06:00 [medline]
AID - 10.1007/s00198-011-1574-5 [doi]
PST - ppublish
SO  - Osteoporos Int. 2012 Jan;23(1):277-84. doi: 10.1007/s00198-011-1574-5. Epub 2011 
      Mar 2.