Long-term safety concerns of antiresorptive theropy, eg AA and risedronate

[Exflex]

Link: ncbi.nlm.nih.gov/pmc/articl...

[PMRpro Ambassador]

This is actually a relatively old publication - from 2011. Many of the concerns will have been addressed since then.

[Exflex in reply to PMRpro]

Right, sorry I had not clocked the publication date.

In what way have the concerns been addressed since then?

[PMRpro Ambassador in reply to Exflex]

The recommendations are for a drug holiday after 3 to 5 years which reduces the risks of these long term adverse effects, There is also more resistance to using it automatically and emphasis on need. There should always be a balance of risk and benefit and sometimes the risk of fractures is greater than that of the adverse effects. Np, I know it is still not perfect - but people are more aware. Back then, many doctors had been convinced it was the best thing since sliced bread

[Exflex in reply to PMRpro]

I stopped taking risedronate after 3 years having read on here the effects. When I was diagnosed with PMR over 4 years ago I was put on Pred and AA and I didn’t question as I was relieved to get rid of the pain. The junior rheumatologist did not mention any side effects at the time of prescribing and I find that annoying. Strangely, I had a DEXA scan in August last year and although my scores were all positive, the report recommended to keep taking risedronate. I find that really inappropriate and rather annoying to be honest.

[PMRpro Ambassador in reply to Exflex]

If the results were positive - do you mean they had + in front of the number? Or just that you had good bone density?

[piglette in reply to Exflex]

More recent research has shown that “long-term AA use results in over suppression of bone turnover (a state of frozen bone), leading to an accumulation of microdamage and increased susceptibility to low trauma fracture. “

[Exflex]

T scores (I think they were T and not Z) we’re all positive, ie had the + symbol in front of the values.

[piglette in reply to Exflex]

I have positive T and Z scores. However it did not stop my GP harping on about taking AA every time I talked to him. I assume he had read somewhere about PMR and one should take AA.

[PMRpro Ambassador in reply to Exflex]

Which may mean there are signs of arthritis - which can cause a false elevation of the readings. Nothing is simple! They also calculate what is called a FRAX score - your risk of a fracture in subsequent years.