Men's Osteoporosis Support Group

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Once-weekly Actonel for male osteoporosis

J Bone Miner Res. 2008 Dec 2. [Epub ahead of print], Once-Weekly Risedronate in Men with Osteoporosis: Results of a 2-Year, Placebo-Controlled, Double-Blind, Multicenter Study. Boonen S and others. PMID: 19049326.

This was a two-year study involving 284 men 30 years or older with either lumbar spine osteoporosis or femoral neck osteopenia. Two-thirds of the men took 35-mg risedronate (Actonel) once-weekly and one-third of them were on placebo. All patients took 1000 mg elemental calcium and 400-500 IU vitamin D daily. Results were measured as increase in bone mineral density (BMD) and decreases in bone turnover markers (BTMs). The treatment group had a statistically significant improvement in the lumbar spine BMD of 4.5% (p<0.001). There was no difference in fracture rate between the two groups, with few fractures reported for either group. There was also no apparent difference in the pattern or distribution of adverse events between the two groups. Changes in BTM were noted as early as three months and in six months for BMD. The authors conclude: "The effects of risedronate treatment on BMD and BTMs in this study were similar to those previously shown to be associated with fracture risk reductions in women with postmenopausal osteoporosis."

Editor's comments. These results can be compared to a recent German study involving men who were taking 5-mg Actonel daily for two years. Rheumatol Int. 2008 Sep 2. [Epub ahead of print], Sustained efficacy of risedronate in men with primary and secondary osteoporosis: results of a 2-year study. Ringe JD and others. PMID: 18762944. The Ringe and others study found a two-year increase in lumbar spine BMD of 6.5% and significant reduction in vertebral and non-vertebral fractures. In general these two studies show that Actonel is equally effective in men as in women at increasing BMD and (in the Ringe and others study) at decreasing fracture risk.

The convenience of the once-weekly dosing means that virtually all men taking Actonel will be using that dosage, or even the recently approved once-monthly dosage. The effectiveness appears similar with either doses, so you might want to discuss which dose option is best for you with your care provider.

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