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DGReview
Bisphosphonate Differ In Gastric-Ulcer Rates
A DGReview of :"14 Day Endoscopy Study Comparing Risedronate and Alendronate in Postmenopausal Women Stratified by Helicobacter pylori Status"
Journal of Rheumatology
10/07/2002
By Robert Short
The bisphosphonate risedronate is associated with fewer gastric ulcers than does alendronate, according to a study of postmenopausal women.
The 14-day endoscopy study of 317 healthy postmenopausal women was carried out by the Risedronate Endoscopy Study Group. The group's first author was Alan Thomson, MD, University of Alberta, Edmonton, Alberta, Canada.
The women were randomly allocated to either risedronate 5 mg/day or alendronate 10 mg/day for 14 days and were stratified by their status to Helicobacter pylori.
Overall, gastric ulcers of 3 mm or greater were seen in 6 percent of evaluable subjects in the risedronate group. In contrast, double the proportion of such ulcers were found in the alendronate group during treatment; there were 12.1 percent in the alendronate group.
At Day 8, the incidences of gastric ulcers in the risedronate group was 3.6 percent and in the alendronate group 6.6 percent. At Day 15, the incidences of gastric ulcers in the risedronate group was 3.3 percent and in the alendronate group 8.7 percent. At Days 8 and 15, the mean gastric endoscopy scores were significantly lower in the risedronate group than in the alendronate group.
The H. pylori[ status of the women did not affect the incidence of gastric ulcers in the separate treatment groups. When the treatment groups were combined, Day 8 and Day 15 gastric endoscopy scores were significantly higher among women who were H pylori negative compared with those who were H pylori positive.
Upper gastrointestinal adverse events were seen in 5.7 percent of subjects in the risedronate group and 8.8 percent of subjects in the alendronate group. However, symptoms did not predict the presence of mucosal damage.
The researchers concluded, "The findings from this 14-day study in healthy volunteers support the hypothesis that bisphosphonates may differ from one another in their potential to produce upper gastrointestinal mucosal damage."
J Rheumatol 2002;29:1965-74.
"14 Day Endoscopy Study Comparing Risedronate and Alendronate in Postmenopausal Women Stratified by Helicobacter pylori Status"
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