Harold Rosen, MD
Potential Financial Conflicts of Interest: None disclosed.
Rosen H.; Review of Comparative Effectiveness of Treatments to Prevent Fractures. Ann Intern Med. 2008;148:884. doi: 10.7326/0003-4819-148-11-200806030-00016
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Published: Ann Intern Med. 2008;148(11):884.
TO THE EDITOR:
I greatly enjoyed the systematic review (1) by MacLean and colleagues on treatments for osteoporosis. However, I disagree with 1 point. Although it is true that they “identified 1 trial on the efficacy of alendronate fracture prevention in patients with renal insufficiency compared with those without renal insufficiency” (2), the authors did not mention another similar analysis documenting the efficacy of risedronate for prevention of fractures in patients with renal insufficiency (3). The article on efficacy of risedronate in patients with chronic kidney disease is especially important, because it documented fracture efficacy of risedronate in patients with glomerular filtration rate less than 30 mL/min per 1.73 m2 or stage 4 chronic kidney disease, whereas the article that the authors cited reported on patients with glomerular filtration rates as low as 30 to 45 mL/min per 1.73 m2.
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