Clodronate Reduces the Incidence of Fractures in Community‐Dwelling Elderly Women Unselected for Osteoporosis: Results of a Double‐Blind, Placebo‐Controlled Randomized Study

摘要: A 3-year prospective, randomized, placebo-controlled trial of oral clodronate 800 mg showed that the incidence clinical fractures was decreased by 20% in 5596 elderly women unselected for osteoporosis. The effect occurred absence systematic calcium and vitamin D supplementation observed across a wide range BMDs. Introduction: To date, most studies with bisphosphonates have reported on their use individuals selected to be at high risk fracture usually presence low BMD or prior fragility fracture, spine. We wished determine bisphosphonate, clodronate, rate ⩾75 years age living community. Materials Methods: Women general community South Yorkshire North Derbyshire, identified from practice registers, were recruited letter invitation double-blind, controlled (Bonefos) matching placebo daily over 3 years. main outcomes incidences hip any fracture. Results: Of 5579 included intention-to-treat analysis efficacy, 114 had new during treatment phase: 56 (2.0%) group 58 (2.1%) (hazard ration [HR], 1.02; 95% CI, 0.71–1.47). Clodronate did, however, decrease (264 [9.5%] versus 337 [12.1%] group; HR, 0.80; 0.68–0.94). osteoporosis-associated nonhip also significantly 29% (5.2% 7.4%; 0.71; 0.57–0.87). ability reduce osteoporotic independent baseline BMD, but number needed-to-treat lower osteoporosis. Conclusions: Oral can prevent without significant adverse effects community. is not significant, an similar other nonvertebral sites cannot excluded. This study suggests antiresorptive therapies high-risk even normal osteopenic BMD.