Bisphosphonates (alendronate and etidronate) in the management of osteoporosis

Best L, Milne R
Record ID 31998008897
Authors' objectives:

The authors examine whether alendronate and etidronate should be used in the treatment of diagnosed osteoporosis.

Authors' results and conclusions: Alendronate has been demonstrated to reduce rates of hip, wrist and vertebral fractures in well designed RCTs. Etidronate is effective in reducing the incidence of non-vertebral fractures including hip fracture (observational data). Randomised controlled trial evidence has demonstrated benefits in terms of reductions in vertebral fracture and increases in bone mineral density.
Authors' recommendations: The authors find that the choice of target population is critical to the cost-utility of bisphosphonate treatment. If treatment is targeted towards individuals at high risk of fracture then both alendronate and etidronate appear to be reasonably cost-effective. However they cannot support the use of etidronate, as RCTs have not detected a reduction in non-vertebral fracture rate, despite suggestions from proxy measures that this may result. Alendronate is preferred, despite it being a more expensive drug, as the quality of evidence for its effectiveness is higher.
Authors' methods: Review
Project Status: Completed
URL for project:
Year Published: 1998
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England
MeSH Terms
  • Alendronate
  • Costs and Cost Analysis
  • Etidronic Acid
  • Diphosphonates
  • Osteoporosis
Organisation Name: Wessex Institute for Health Research and Development
Contact Address: Pauline King. Wessex Institute for Health Research and Development, Boldrewood Medical School, Bassett Crescent East, Highfield, Southampton. SO16 7PX Tel. +44 1703 595661 Fax +44 1703 595662
Copyright: Wessex Institute for Health Research and Development (WIHRD)
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