Risedronate improves proximal femur bone density and geometry in patients with osteoporosis or osteopenia and clinical risk factors of fractures: a practice-based observational study

The purpose of this practice-based observational study was to clarify the acute effect of risedronate on proximal femur bone mineral density (BMD) and structural geometry in patients with an increased risk of fractures. One hundred sixty-four patients (7 men and 157 postmenopausal women; mean age, 69.2 years) with osteoporosis or osteopenia and clinical risk factors of fractures were analyzed. All these patients were treated with risedronate for 1 year. Urinary levels of cross-linked N-terminal telopeptide of type I collagen (NTX) were measured at baseline and 4 months after the start of treatment. BMD of the lumbar spine and proximal femur and structural geometric parameters of the proximal femur were evaluated by dual-energy X-ray absorptiometry with advanced hip assessment (AHA) software at baseline and every 4 months. Urinary NTX levels significantly decreased after 4 months of treatment. BMD of the femoral neck and total hip significantly increased after 4, 8, and 12 months of treatment. Cross-sectional moment of inertia (CSMI) and cross-sectional area significantly increased after 4, 8, and 12 months of treatment. An increase in CSMI was apparently greater than those of proximal femur BMD after 4 months of treatment. These results suggest the acute (4 months) and sustained (12 months) effect of risedronate on proximal femur structural geometry as well as BMD as a result of suppression of bone resorption in patients with an increased risk of fractures.