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Use of bisphosphonates found to be less effective for overweight patients with more advanced radiographic knee OA severity

Use of bisphosphonates found to be less effective for overweight patients with more advanced radiographic knee OA severity Use of bisphosphonates found to be less effective for overweight patients with more advanced radiographic knee OA severity
Use of bisphosphonates found to be less effective for overweight patients with more advanced radiographic knee OA severity Use of bisphosphonates found to be less effective for overweight patients with more advanced radiographic knee OA severity

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Bisphosphonates can be effective in patients who do not already have signs of knee damage or who have mild disease, and when damage arises, use of bisphosphonates use may not be as effective.

As concluded from the results of an Osteoarthritis Initiative (OAI), issued online in July, 2020, the use of bisphosphonates may be protective against radiographic knee osteoarthritis (OA) progression in the initial stages, especially those who are not obese, nevertheless not as much for those with more advanced disease or added weightbearing joint stress.

The use of antiresporptive medicines for treatment of knee OA is not new, but not information is available concerning more potent nitrogencontaining oral bisphosphonates on radiographic diseaseprogression in patients with changing diseaseseverity, especially those who are not overweight.

This study focused to determine if use of bisphosphonates is protective against 2year radiographicprogression of knee OA in OAI patients, stratified by baseline radiographic diseasestatus and assess effects in nonoverweight patients (BMI < 25 kg/m2) and cumulative bisphosphonate exposure effects.

Women patients aged ≥50 years were recognized and excepted those missing baseline radiograph readings, bisphosphonate use data, or all clinical survey information at baseline. These women participants with bisphosphonate use (69% alendronate) were propensitymatched 1:1 to nonbisphosphonateusers. They were followed till first radiographic knee OAprogression (1unit surge in Kellgren and Lawrence i.e. KL grade) or data were amended (first missed visit or end of 2year followup). The hazardratios between bisphosphonateusers versus nonusers, with an interaction term for baseline KL grade (KL < 2 or KL≥2) were evaluated via discretetime logistic regression models.

On the whole, 346 bisphosphonateusers were recognized in a total of 1,977 eligible women. 


As shown in the table, Bisphosphonateusers with KL grade < 2 were safe against progression, whereas bisphosphonate use was not linked with radiographic progression in those with KL grade ≥ 2. When limiting the analysis to those patients with BMI < 25 kg/m2, effects were reinforced. The bisphosphonate use period did not affect progression, though sample size was limited. 

Source:

The American Society for Bone and Mineral Research

Article:

Bisphosphonate use is protective of radiographic knee osteoarthritis progression among those with low disease severity and being non‐overweight: data from the Osteoarthritis Initiative

Authors:

Kaleen N. Hayes et al.

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