Efficacy and safety of sodium RISedronate for glucocorticoid-induced OsTeoporosis with rheumaTOid arthritis (RISOTTO study): A multicentre, double-blind, randomized, placebo-controlled trial

Mod Rheumatol. 2021 May;31(3):593-599. doi: 10.1080/14397595.2020.1812835. Epub 2020 Oct 2.

Abstract

Objective: No evidence has shown the efficacy of Sodium Risedronate (Risedronate) for glucocorticoid-induced osteoporosis (GIO) in patients with Rheumatoid arthritis (RA). The aim of this study was to explore the effectiveness and safety of Risedronate for GIO complicated with RA.

Methods: This was a six-month randomized, double-blind, placebo-controlled trial of 95 patients with GIO complicated with RA from 19 centers. The primary endpoint was the change from baseline in lumbar spine bone mineral density (L-BMD). Secondary endpoints included changes in femoral neck and total hip BMD and bone turnover markers, as well as rheumatoid arthritis Disease Activity Score with 28-joint counts. Incident of non-traumatic spine fractures and adverse events were tracked as safety endpoints.

Results: Increase in L-BMD was significantly greater in the Risedronate group compared to the Placebo group (Risedronate: 3.49% [95% CI: 1.92-5.05] vs Placebo: 0.12% [95% CI: -2.07 to 2.30], p < .0001). No significant difference was found in the femoral neck and total hip BMD. Although adverse events were observed in 28 patients, none were considered serious. Non-traumatic vertebral fractures were identified in 10 patients.

Conclusion: Risedronate was effective in increasing L-BMD and was well tolerated in patients with GIO complicated with RA.

Keywords: Glucocorticoid-induced osteoporosis; randomized control study; rheumatoid arthritis; sodium risedronate.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Arthritis, Rheumatoid / drug therapy
  • Bone Density
  • Bone Density Conservation Agents / administration & dosage
  • Bone Density Conservation Agents / adverse effects
  • Bone Density Conservation Agents / therapeutic use*
  • Double-Blind Method
  • Female
  • Glucocorticoids / adverse effects
  • Glucocorticoids / therapeutic use
  • Humans
  • Lumbar Vertebrae / pathology
  • Male
  • Middle Aged
  • Osteoporosis / drug therapy*
  • Osteoporosis / etiology
  • Risedronic Acid / administration & dosage
  • Risedronic Acid / adverse effects
  • Risedronic Acid / therapeutic use*

Substances

  • Bone Density Conservation Agents
  • Glucocorticoids
  • Risedronic Acid