Effects of Risedronate Treatment on Vertebral and Nonvertebral Fractures in Women With Postmenopausal Osteoporosis A Randomized Controlled Trial

DECLINING ESTROGEN LEVELS at menopause result in increased bone turnover and a loss of bone mass, with subsequent increases in bone fragility and the risk of bone fracture. Vertebral fracture, in particular, is a common consequence of osteoporosis and may be considered the hallmark fracture for osteoporosis in postmenopausal women. Because of the high frequency of vertebral fractures in patients with postmenopausal osteoporosis, clinical trials of osteoporosis therapies now typically assess the effects of treatment on vertebral fracture incidence as the primary end point. Prevention of nonvertebral fractures is another important goal of treatment because of the pain and disability associated with these fractures. Several therapies have demonstrated antifracture efficacy in the treatment of established postmenopausal Author Affiliations, Members of the Vertebral Efficacy With Risedronate Therapy (VERT) Study Group, and Financial Disclosures are listed at the end of this article. Corresponding Author and Reprints: Steven T. Harris, MD, University of California, San Francisco, 350 Parnassus Ave, Suite 706, San Francisco, CA 94117-3608. Context Risedronate, a potent bisphosphonate, has been shown to be effective in the treatment of Paget disease of bone and other metabolic bone diseases but, to our knowledge, it has not been evaluated in the treatment of established postmenopausal osteoporosis.