Etidronate therapy in the treatment and prevention of osteoporosis

Etidronate disodium is an oral bisphosphonate compound known to reduce bone resorption through the inhibition of osteoclastic activity. This article i s a review of its efficacy and safety in the treatment and prevention of po stmenopausal and corticosteroid-induced osteoporosis. In general, studies o f cyclical etidronate therapy (400 mg daily for 2 wk every 3 mo) have found a significant improvement in bone density. These studies have not been pow ered to study fracture incidence, but a reduced fracture rate has been foun d in some of the studies reviewed. Studies examining cyclical etidronate in the prevention of osteoporosis ind icate it prevents early menopausal bone loss and is free of significant sid e effects. In both prevention of corticosteroid-induced osteoporosis and tr eatment of patients who have been on long-term corticosteroid therapy, cycl ical etidronate appears to increase bone density and prevent further loss o f bone. In summary, a review of available literature pertaining to the use of etidr onate in the prevention and treatment of primary and secondary osteoporosis has been presented. This review suggests etidronate, used as a cyclical th erapy, is a safe and effective therapy. The weight of evidence suggests tha t it is capable of reducing fracture risk in patients with osteoporosis. In creases in bone density at the spine and hip are not as pronounced as with some other bisphosphonates, particularly alendronate, but no direct clinica l comparison trials of significant size or duration have been undertaken.