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Monthly Risedronate for the Treatment of Postmenopausal Osteoporosis

Jun Iwamoto

Risedronate is a first-line medicine for the treatment of postmenopausal osteoporosis, since meta-analyses of large randomized controlled trials have demonstrated its efficacy against vertebral, nonvertebral, and hip fractures. Risedronate has desirable pharmacological characteristics in terms of its low affinity for bone, and its strong inhibition of farnesyl pyrophosphate synthase rapidly reduces bone turnoverand reverses the effect. Monthly risedronate, which has been recently approved, is non-inferior to daily risedronate in terms of changes in surrogate markers and the incidence of adverse effects. However, the incidence of acute phase reactions is higher for a monthly dosing regimen than for a daily dosing regimen. Because monthly bisphosphonates are superior to weekly bisphosphonates in terms of patient preference and convenience and, consequently, treatment adherence (particularly persistence), monthly risedronate is considered to be useful in clinical practice