Alendronate better than risedronate at increasing BMD

Weekly treatment with alendronate is more effective in building bone in the hip and spine than weekly risedronate, according to a new head-to-head study of the drugs. The findings were from a post-hoc analysis of FACT (Fosamax Actonel Comparator Trials), a double-blind, randomized trial of alendronate and risedronate. More than 1,000 postmenopausal women with and without osteoporosis were enrolled in the 12-month trial.

Weekly alendronate (70 mg) was significantly more effective in increasing hip trochanter, lumbar spine, and total hip bone mineral density (BMD), regardless of a patient's osteoporotic status. In women with osteoporosis, alendronate increased BMD by 3.6%, 3.6%, and 2.1% in those sites, respectively, compared with 2.0, 2.5, and 1.0 for risedronate (35 mg). The osteoporotic patients on alendronate also had greater decreases in biochemical markers indicative of their condition than did their counterparts taking risedronate. No significant differences were seen between the two treatments in adverse events, including upper gastrointestinal problems.