Etidronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women

Wells GA, Cranney A, Peterson J, Boucher M, Shea B, Welch V, Coyle D, Tugwell P

Summary

Etidronate for preventing fractures caused by osteoporosis in postmenopausal women

This summary of a Cochrane review presents what we know from research about the effect of etidronate for preventing fractures (broken bones) caused by osteoporosis.

In women who have already been diagnosed with low bone density, putting them at risk of a fracture or have already had a fracture in the bones of their spine, etidronate:

-may prevent fractures in the bones of the spine.

- may lead to no difference in hip or wrist fractures or fractures in the bones other than in the spine.

In women whose bone density is closer to normal or who may not have had a fracture in the bones of their spine yet, etidronate:

- may lead to no difference in fractures in the bones of the spine, or in bones other than those of the spine.

- it is not known whether etidronate prevents hip or wrist fractures since no evidence was found that looked at the effect of etidronate in these women.

We often do not have precise information about side effects and complications. This is particularly true for rare but serious side effects. Possible side effects may include digestive problems such as heartburn, nausea and upset stomach.

What is osteoporosis and what is etidronate?
Bone is a living, growing part of your body. Throughout your lifetime, new bone cells grow and old bone cells break down to make room for the new, stronger bone. When you have osteoporosis, the old bone breaks down faster than the new bone can replace it. As this happens, the bones lose minerals (such as calcium). This makes bones weaker and more likely to break even after a minor injury, like a little bump or fall.

Women who have gone through menopause are more likely to get osteoporosis than other people. Etidronate belongs to the class of drugs called bisphosphonates. It is a type of medication that slows down the cells that break down the old bone.

The best estimate of what happens to women that have already been diagnosed with low bone density or have already had a fracture in the bones of their spine:

Fracture of the spine:

                 - 11 out of 100 women had a fracture when taking a placebo

                 - 6 out of 100 women had a fracture when taking etidronate

Fractures in bones other than the spine:

                 - 13 out of 100 women had a fracture when taking a placebo

                 - 14 out of 100 women had a fracture when taking etidronate

Fractures in the hip or wrist:

                 - there was no difference in the number of women who had hip or wrist fractures which may be the result of chance

The best estimate of what happens to women whose bone density is closer to normal or who may not yet have had a fracture in the bones of their spine:

Fracture of the spine

                 - 0 out of 100 women had a fracture when taking a placebo

                 - 1 out of 100 women had a fracture when taking etidronate

Fractures in bones other than the spine

                 - 11 out of 100 women had a fracture when taking a placebo

                 - 6 out of 100 women had a fracture when taking etidronate

For these women, fractures in the hip or wrist were not measured in the studies.