In our study, after 2 years of treatment, no histological or mineralization abnormalities were observed in any of the risedronate-treated groups. Importantly, persistent bone turnover was evident as noted by the presence of tetracycline label in all 45 biopsy samples. This contrasts with the histomorphometric
results with alendronate and denosumab that demonstrated absent tetracycline labels in many subjects [29, 30]. This apparent difference in the level of turnover observed on treatment is consistent with the study by Rosen and colleagues in which the approved dose of alendronate (70 mg weekly) reduced markers of bone turnover significantly more than did the approved dose of risedronate IR (35 mg Selleck Pirfenidone weekly) . The clinical implications of the reported differences among different drugs
on indices of bone turnover are not known, but knowing that bone remodeling is not “over suppressed” with risedronate is reassuring. Overall, the tolerability of the weekly DR regimens was similar to that observed with the daily IR treatment. These data are consistent with previous studies in which the tolerability was similar in subjects receiving placebo or daily IR risedronate and in subjects receiving weekly or monthly IR risedronate compared to daily IR therapy. Upper abdominal pain occurred somewhat more frequently in the DR BB groups while slightly more subjects experienced diarrhea with the DR FB regimen, but Panobinostat nmr these differences did not result in more subjects discontinuing from study medication. As expected, no cases of osteonecrosis of the jaw or atypical femoral fractures were observed in these subjects who received treatment for only 2 years. These data support the results of previous large studies that demonstrated good tolerability and short-term safety of risedronate therapy. The number of
subjects experiencing clinical fractures was very low, precluding the chance of observing differences among dosing regimens. Thus, it is unclear whether the greater effects of the DR regimen on bone mineral density and bone turnover, compared to IR daily dosing, would result in better fracture protection. These 2-year results confirm that weekly administration of the 35-mg DR formulation results in changes in BMD and bone turnover that are at least as effective in increasing Nintedanib (BIBF 1120) BMD and reducing bone turnover as the daily IR dosing regimen that is known to significantly reduce the incidence of fragility fractures in postmenopausal women with osteoporosis. A weekly dosing regimen that can be taken following breakfast is more convenient for many subjects with busy schedules or in older subjects who must take many other medications each morning. More importantly, the DR formulation of risedronate provides confidence to clinicians that poor compliance with dosing recommendations will be less likely to blunt the therapeutic effectiveness of risedronate.