Role of Triticum aestivum aqueous extract in glucocorticoid induced osteoporosis in rats.

Administration of aqueous extract of T. aestivum (200 and 400 mg/kg/day, po, for 30 days) and risedronate (20 mg/kg, sc, five times a week for 30 days) following methyl prednisolone sodium succinate (10 mg/kg, sc, thrice a week for 4 weeks) induced osteoporosis in Wistar rats showed an increase in the serum levels of bone mineral content markers, decrease in the serum and urinary levels of bone resorption markers. An incline in strength of femur and tibia was seen particularly with 400 mg/kg of T. aestivum. Maintenance of calcium homeostasis, formation of collagen and scavenging of free radicals can plausibly be the mode of action of aqueous extract of T. aestivum thereby combating osteoporosis induced by glucocorticoids.

Effects of Risedronate on Osteoarthritis of the Knee

The purpose of the present study was to discuss the effects of risedronate on osteoarthritis (OA) of the knee by reviewing the existing literature. The literature was searched with PubMed, with respect to prospective, double-blind, randomized placebo-controlled trials (RCTs), using the following search terms: risedronate, knee, and osteoarthritis. Two RCTs met the criteria. A RCT (n = 231) showed that risedronate treatment (15 mg/day) for 1 year improved symptoms. A larger RCT (n = 1,896) showed that risedronate treatment (5 mg/day, 15 mg/day, 35 mg/week, and 50 mg/week) for 2 years did not improve signs or symptoms, nor did it alter radiological progression. However, a subanalysis study (n = 477) revealed that patients with marked cartilage loss preserved the structural integrity of subchondral bone by risedronate treatment (15 mg/day and 50 mg/week). Another subanalysis study (n = 1,885) revealed that C-terminal crosslinking telopeptide of type II collagen (CTX-II) decreased with risedronate treatment in a dose-dependent manner, and levels reached after 6 months were associated with radiological progression at 2 years. The results of these RCTs show that risedronate reduces the marker of cartilage degradation (CTX-II), which could contribute to attenuation of radiological progression of OA by preserving the structural integrity of subchondral bone. The review of the literature suggests that higher doses of risedronate (15 mg/day) strongly reduces the marker of cartilage degradation (CTX-II), which could contribute to attenuation of radiological progression of OA by preserving the structural integrity of subchondral bone.

[Effects of risedronate on bone turnover markers in osteoporotic postmenopausal women: comparison of two protocols of treatment]

Bisphosphonates are powerful agents able to prevent bone loss. The objective of the study was to evaluate the efficacy and tolerability of risedronate once a week [35 mg] compared with risedronate 5 mg once daily in women with osteoporosis. A randomized, double-blind, active controlled study enrolled 102 postmenopausal women aged 66.5+7.5 years with osteoporotic fractures. All women received risedronate during 6 months. Group 1 [G1, n=51] received risedronate 5 mg once daily and group 2 [G2, n=51] received 35 mg once a week. Serum alkaline phosphatase [ALP], bone alkaline phosphatase [bone ALP], serum C-terminal telopeptide of type I collagen [CTX] were measured at baseline, 3 months and 6 months after treatment in the two groups. We noted no significant difference in markers between women of the 2 groups. After 3 months, bone ALP and CTX decreased [respectively -22.1% and -47.6%] in the 2 groups with no significant difference between them. After 6 months study, bone ALP and CTX decreased respectively by -46.5% and -62.9% with no statistically significant difference between study groups for bone markers. Our study found that treatment with once weekly risedronate 35 mg is able to decrease CTX and bone ALP compared with risedronate 5 mg once daily, in postmenopausal women with osteoporotic fractures. We didn't find adverse events with the 35 mg once a-week dose group compared to the once-daily dose group. Based on these results, the effects of risedronate 35 mg once a week are similar in efficacy to daily dosing and may lead less adverse events than once-a month dose. This therapeutic protocol may provide an alternative for patients who prefer once a week oral dosing

Comparison of the Effect of Vitamin K2 and Risedronate on Trabecular Bone in Glucocorticoid-Treated Rats: A Bone Histomorphometry Study

PURPOSE: To compare the effect of vitamin K2 and risedronate on trabecular bone in glucocorticoid (GC)-treated rats. MATERIALS AND METHODS: Forty-eight Sprague-Dawley female rats, 3 months of age, were randomized by the stratified weight method into 5 groups according to the following treatment schedule: age-matched control, GC administration, and GC administration with concomitant administration of vitamin K2, risedronate, or vitamin K2 + risedronate. GC (methylprednisolone sodium succinate, 5.0 mg/kg) and risedronate (10 microgram/kg) were administered subcutaneously three and five times a week, respectively. Vitamin K2 (menatetrenone, 30 mg/kg) was administered orally three times a week. At the end of the 8-week experiment, bone histomorphometric analysis was performed on trabecular bone of the tibial proximal metaphysis. RESULTS: GC administration decreased trabecular bone mass compared with age-matched controls because of decreased bone formation (mineralizing surface, mineral apposition rate, and bone formation rate) and increased bone erosion. Vitamin K2 attenuated GC-induced trabecular bone loss by preventing GC-induced decrease in bone formation (mineralizing surface) and subsequently reducing GC-induced increase in bone erosion. Risedronate prevented GC-induced trabecular bone loss by preventing GC-induced increase in bone erosion although it also suppressed bone formation (mineralizing surface, mineral apposition rate, and bone formation rate). Vitamin K2 mildly attenuated suppression of bone formation (mineralizing surface) and bone erosion caused by risedronate without affecting trabecular bone mass when administered in combination. CONCLUSION: The present study showed differential effect of vitamin K2 and risedronate on trabecular bone in GC-treated rats.

Osteoporotic fracture management in India: a survey of orthopaedic surgeons.

Osteoporosis is widely prevalent in India and osteoporotic fractures are a common cause of morbidity and mortality. A survey was conducted to obtain information regarding views of Indian orthopaedic surgeons about criteria used for diagnosing and treating osteoporosis, and treatment duration with bisphosphonates, the recommended drugs for osteoporosis. The survey was carried out at Indian Orthopaedic Association Conference (IOACON) in November 2006 using two types of forms--form 'A' contained information pertaining to clinical history and assessed the duration of patients' compliance with bisphosphonates, while form 'B' contained information on investigations as well for the same cases and assessed the duration of treatment effect with risedronate and alendronate. Of 1,054 orthopaedic surgeons who participated, 591 answered form 'A' and 463 answered form 'B'. Results showed that 78% of orthopaedic surgeons diagnose osteoporosis based on clinical history and majority of them were willing to prescribe bisphosphonates. However, they believed that two-thirds of all patients took drugs for 6 months or less. Of 409 surgeons who answered the question on risedronate, 55% believed its treatment effect was seen within 3 months, as compared to only 35% of 350 surgeons who answered for alendronate. The survey results highlight the need to better manage certain aspects of osteoporosis as regards diagnosis, drug choice and treatment duration in India.

Comparative therapeutic use of Risedronate and Calcarea phosphorica - allopathy versus homeopathy - in bone repair in castrated rats / Comparação do uso terapêutico de Risedronato e Calcarea phosphorica - alopatia versus homeopatia - no reparo ósseo em ratos castrados

Osteoporosis, a disease characterized by progressive bone loss, has been the target of several studies in the past few years. It results in a much higher risk for fractures and might cause slower bone lesion healing. The aim of this work was to study the effects of Risedronate (allopathic medicine) and Calcarea phosphorica 6CH (homeopathic medicine) on the repair of bone lesions in male rats with osteoporosis induced by castration. Eighty-four three-month-old rats were used divided into four groups of twenty-one animals each. Three groups where castrated and one group was submitted to Sham surgery. One month later, cortical lesions were made in all animals' tibiae and, after one day, the different experimental treatments began according to the following groups: CR - castrated/Risedronate (1 mg/kg/day); CCp - castrated/Calcarea phosphorica 6CH (3 drops/day); CP - castrated/placebo and SP - Sham/placebo. The animals were sacrificed at seven, fourteen and twenty-eight days after the beginning of the treatments and had their tibiae removed. Digital radiographs of the tibiae were taken and analyzed in order to evaluate the optical density of the defect area. Then, they were decalcified and processed for histological and histomorphometrical analysis. The data were submitted to ANOVA, and to the Tukey and Dunnett tests (5 percent). The allopathic and homeopathic treatments led to different bone formation as regards remodeling and maturation aspects. Further research is necessary to access the resistance and quality of the newly formed bone.

A osteoporose, doença caracterizada pela perda de massa óssea, tem sido alvo de estudos nos últimos anos. Fraturas decorrentes da osteoporose são muito comuns e podem apresentar consolidação mais lenta. O objetivo deste trabalho foi avaliar o efeito do risedronato (medicamento alopático) e da Calcarea phosphorica 6CH (medicamento homeopático) no reparo de lesões ósseas em ratos com osteoporose induzida por castração. Para tanto, foram utilizados oitenta e quatro ratos, com três meses de idade, separados em quatro grupos de vinte e um animais, sendo três grupos submetidos à castração e um grupo a falsa cirurgia ("Sham"). Um mês após a cirurgia, foram realizadas lesões corticais na tíbia de todos os animais e, a partir do dia seguinte, os tratamentos experimentais foram iniciados de acordo com os seguintes grupos: CR - castrado/risedronato (1 mg/kg/dia); CCp - castrado/Calcarea phosphorica 6CH (três gotas/dia); CP - castrado/placebo e SP - "sham"/placebo. Os animais foram sacrificados aos sete, catorze e vinte e oito dias após o início do tratamento e as tíbias foram removidas. Radiografias digitais foram realizadas e avaliadas para obter a densidade óptica na área do defeito. Em seguida, foram descalcificadas e processadas para análise histológica e histomorfométrica. Os dados foram submetidos a ANOVA e aos testes de Tukey e Dunnett (5 por cento). Os tratamentos alopático e homeopático levaram a formação óssea de aspecto diferente considerando a remodelação e maturação. Mais pesquisas são necessárias para avaliar a resistência e qualidade do osso neoformado.

Efficacy and safety of risedronate sodium in treatment of postmenopausal osteoporosis / 华中科技大学学报（医学）（英德文版）

To evaluate the efficacy and safety of risedronate sodium in treatment of postmenopausal osteoporosis, one-year randomized, double blind clinical trial was performed among 54 women with postmenopausal osteoporosis. The changes were compared in bone mineral density (BMD), bone metabolism markers and adverse events after 12 months oral administration of risedronate sodium. BMD was measured by dual energy X-ray absorptionmetry (DEXA) and bone turnover marker was detected. The results showed that there was a significant increase in BMD of the lumbar spine (3.29% +/- 1.18%, 4.51% +/- 1.64% respectively) after 6 and 12 months in the risedronate treatment group versus placebo control group (-0.62% +/- 0.24%, 0.48% +/- 0.18% respectively). Bone turnover was decreased to a stable nadir over 6 and 12 months for resorption markers [N-Telopeptide (NTx), P < 0.05] and over 12 months for formation marker (ALP, P < 0.05; BGP, P < 0.05). The safety profile of risedronate sodium was similar to that of placebo. There were no trends toward increased frequency of any adverse experience except for gastrointestinal symptoms (7.1%), rash (7.1%) and hematuria (3.6%), which were usually mild, transient, and resolved with continued treatment. It was concluded that risedronate was an efficacious and safe drug in treatment of postmenopausal osteoporosis.