etidronic acid


Summary: A diphosphonate which affects calcium metabolism. It inhibits ectopic calcification and slows down bone resorption and bone turnover.

Top Publications

  1. Delmas P, Benhamou C, Man Z, Tlustochowicz W, Matzkin E, Eusebio R, et al. Monthly dosing of 75 mg risedronate on 2 consecutive days a month: efficacy and safety results. Osteoporos Int. 2008;19:1039-45 pubmed
    ..Both treatments were generally well tolerated and safe. Risedronate 75 mg 2CDM was non-inferior in efficacy and did not show a difference in safety vs. 5 mg daily after 12 months, leading to a similar benefit. ..
  2. Orita S, Ohtori S, Koshi T, Yamashita M, Yamauchi K, Inoue G, et al. The effects of risedronate and exercise on osteoporotic lumbar rat vertebrae and their sensory innervation. Spine (Phila Pa 1976). 2010;35:1974-82 pubmed publisher
    ..Risedronate suppressed activity of CGRP-ir neurons in vitro, improved BMD, and decreased CGRP expression, especially together with exercise in vivo. ..
  3. Roelofs A, Coxon F, Ebetino F, Lundy M, Henneman Z, Nancollas G, et al. Fluorescent risedronate analogues reveal bisphosphonate uptake by bone marrow monocytes and localization around osteocytes in vivo. J Bone Miner Res. 2010;25:606-16 pubmed publisher
    ..In conclusion, this study shows that in addition to bone-resorbing osteoclasts, bisphosphonates may exert direct effects on bone marrow monocytes in vivo. ..
  4. Markopoulos C, Tzoracoleftherakis E, Polychronis A, Venizelos B, Dafni U, Xepapadakis G, et al. Management of anastrozole-induced bone loss in breast cancer patients with oral risedronate: results from the ARBI prospective clinical trial. Breast Cancer Res. 2010;12:R24 pubmed publisher
  5. Fuchs R, Phipps R, Burr D. Recovery of trabecular and cortical bone turnover after discontinuation of risedronate and alendronate therapy in ovariectomized rats. J Bone Miner Res. 2008;23:1689-97 pubmed publisher
    ..Despite reductions in BMD and increases in bone turnover, ultimate force of the fifth lumbar vertebra remained significantly higher in all drug-treated animals through 16 wk after withdrawal. ..
  6. Masud T, McClung M, Geusens P. Reducing hip fracture risk with risedronate in elderly women with established osteoporosis. Clin Interv Aging. 2009;4:445-9 pubmed
    ..4% of placebo-treated patients (relative risk 0.54; 95% confidence interval 0.32-0.91; P = 0.019). Risedronate significantly reduced the risk of hip fracture in women aged up to 100 years with established osteoporosis. ..
  7. Feher A, Koivunemi A, Koivunemi M, Fuchs R, Burr D, Phipps R, et al. Bisphosphonates do not inhibit periosteal bone formation in estrogen deficient animals and allow enhanced bone modeling in response to mechanical loading. Bone. 2010;46:203-7 pubmed publisher
  8. Lottanti S, Gautschi H, Sener B, Zehnder M. Effects of ethylenediaminetetraacetic, etidronic and peracetic acid irrigation on human root dentine and the smear layer. Int Endod J. 2009;42:335-43 pubmed publisher
  9. Chevalier Y, Quek E, Borah B, Gross G, Stewart J, Lang T, et al. Biomechanical effects of teriparatide in women with osteoporosis treated previously with alendronate and risedronate: results from quantitative computed tomography-based finite element analysis of the vertebral body. Bone. 2010;46:41-8 pubmed publisher

More Information


  1. Dalle Carbonare L, Bertoldo F, Valenti M, Zordan S, Sella S, Fassina A, et al. Risedronate prevents the loss of microarchitecture in glucocorticoid-induced osteoporosis in rats. J Endocrinol Invest. 2007;30:739-46 pubmed
    ..Ris counteracted these effects both by prolonging osteoblast activity, and by maintaining bone microarchitecture. ..
  2. Marx R, Cillo J, Ulloa J. Oral bisphosphonate-induced osteonecrosis: risk factors, prediction of risk using serum CTX testing, prevention, and treatment. J Oral Maxillofac Surg. 2007;65:2397-410 pubmed
    ..To assess the risk and time course of oral bisphosphonate-induced osteonecrosis of the jaws...
  3. Greenspan S, Brufsky A, Lembersky B, Bhattacharya R, Vujevich K, Perera S, et al. Risedronate prevents bone loss in breast cancer survivors: a 2-year, randomized, double-blind, placebo-controlled clinical trial. J Clin Oncol. 2008;26:2644-52 pubmed publisher
    ..We conclude that in postmenopausal women with breast cancer with or without AI therapy, once-weekly oral risedronate was beneficial for spine and hip BMD, reduced bone turnover, and was well tolerated. ..
  4. Curtis J, Westfall A, Cheng H, Saag K, Delzell E. RisedronatE and ALendronate Intervention over Three Years (REALITY): minimal differences in fracture risk reduction. Osteoporos Int. 2009;20:973-8 pubmed publisher
    ..The absolute rate of clinical fractures among alendronate and risedronate users was similar both at 1 year and beyond, suggesting comparable effectiveness between agents. ..
  5. Lawson M, Xia Z, Barnett B, Triffitt J, Phipps R, Dunford J, et al. Differences between bisphosphonates in binding affinities for hydroxyapatite. J Biomed Mater Res B Appl Biomater. 2010;92:149-55 pubmed publisher
    ..These differences may be exploited in the development of biomaterials and may also partly explain the extent of their relative skeletal retention and persistence of biological effects observed in both animal and clinical studies. ..
  6. Van Poznak C, Hannon R, Mackey J, Campone M, Apffelstaedt J, Clack G, et al. Prevention of aromatase inhibitor-induced bone loss using risedronate: the SABRE trial. J Clin Oncol. 2010;28:967-75 pubmed publisher
  7. Waltman N, Twiss J, Ott C, Gross G, Lindsey A, Moore T, et al. The effect of weight training on bone mineral density and bone turnover in postmenopausal breast cancer survivors with bone loss: a 24-month randomized controlled trial. Osteoporos Int. 2010;21:1361-9 pubmed publisher
    ..66, p = 0.03) and femoral neck (chi-square [1] = 4.63, p = 0.03). Strength/weight training exercises may prevent loss of BMD in postmenopausal BCS at risk for bone loss. ..
  8. Kambayashi Y, Fujimura T, Furudate S, Hashimoto A, Haga T, Aiba S. Comparison of immunosuppressive and cytotoxic cells in angiosarcoma: development of a possible supportive therapy for angiosarcoma. Dermatology. 2013;227:14-20 pubmed publisher
    ..These findings suggest that a high number of immunosuppressive cells might be related to the prognosis of AS, and that a combination of docetaxel with bisphosphonate risedronate sodium might be effective for MMP-9-expressing AS...
  9. Kendler D, Ringe J, Ste Marie L, Vrijens B, Taylor E, Delmas P. Risedronate dosing before breakfast compared with dosing later in the day in women with postmenopausal osteoporosis. Osteoporos Int. 2009;20:1895-902 pubmed publisher
    ..If patients cannot abide by before-breakfast dosing and flexible dosing is an approved option, one can expect suboptimal BMD results with flexible dosing. ..
  10. Chung Y, Lim S, Chung H, Lee I, Park I, Kim G, et al. Comparison of monthly ibandronate versus weekly risedronate in preference, convenience, and bone turnover markers in Korean postmenopausal osteoporotic women. Calcif Tissue Int. 2009;85:389-97 pubmed publisher
    ..There was no significant difference in change of bone turnover marker and safety profile between the two regimens. ..
  11. Bruyere O, Burlet N, Delmas P, Rizzoli R, Cooper C, Reginster J. Evaluation of symptomatic slow-acting drugs in osteoarthritis using the GRADE system. BMC Musculoskelet Disord. 2008;9:165 pubmed publisher
    ..In the benefit/risk ratio, the use of chondroitin sulfate, diacereine, glucosamine sulfate, avocado/soybean unsaponifiables and hyaluronic acid could be of potential interest for the symptomatic management of OA. ..
  12. Kashemirov B, Bala J, Chen X, Ebetino F, Xia Z, Russell R, et al. Fluorescently labeled risedronate and related analogues: "magic linker" synthesis. Bioconjug Chem. 2008;19:2308-10 pubmed publisher
    ..The utility of a fluorescent 1 conjugate in visualizing osteoclast resorption in vitro was demonstrated. ..
  13. Blouin J, Dragomir A, Moride Y, Ste Marie L, Fernandes J, Perreault S. Impact of noncompliance with alendronate and risedronate on the incidence of nonvertebral osteoporotic fractures in elderly women. Br J Clin Pharmacol. 2008;66:117-27 pubmed publisher
    ..28, 95% CI 1.02, 1.61). Among community-dwelling elderly women, noncompliance with alendronate or risedronate is associated with an increased risk of nonvertebral fracture. ..
  14. Cadarette S, Katz J, Brookhart M, STURMER T, Stedman M, Solomon D. Relative effectiveness of osteoporosis drugs for preventing nonvertebral fracture. Ann Intern Med. 2008;148:637-46 pubmed
    ..Nasal calcitonin recipients may have a higher risk for nonvertebral fractures compared with alendronate recipients. Future studies that can better adjust for possible confounding may further clarify these relationships. ..
  15. Eastell R, Vrijens B, Cahall D, Ringe J, Garnero P, Watts N. Bone turnover markers and bone mineral density response with risedronate therapy: relationship with fracture risk and patient adherence. J Bone Miner Res. 2011;26:1662-9 pubmed publisher
    ..Changes greater than the LSC in BTMs and BMD reflect better treatment adherence, were associated with fracture risk reduction, and identify differences in individual responsiveness to risedronate. ..
  16. De Deus G, Zehnder M, Reis C, Fidel S, Fidel R, Galan J, et al. Longitudinal co-site optical microscopy study on the chelating ability of etidronate and EDTA using a comparative single-tooth model. J Endod. 2008;34:71-5 pubmed
    ..05). In addition, the single-tooth model is advantageous over the first co-site optical microscopy dentin assessments when different chelator solutions are compared. ..
  17. Osaki M, Tatsuki K, Hashikawa T, Norimatsu T, Chiba K, Motokawa S, et al. Beneficial effect of risedronate for preventing recurrent hip fracture in the elderly Japanese women. Osteoporos Int. 2012;23:695-703 pubmed publisher
    ..Accordingly, risedronate may have a preventive effect on hip fracture in high-risk Japanese female osteoporosis patients for fracture with a history of unilateral hip fracture. ..
  18. Chung H, Chin S, Kang M, Koh J, Moon S, Yoon B, et al. Efficacy of risedronate with cholecalciferol on 25-hydroxyvitamin D level and bone turnover in Korean patients with osteoporosis. Clin Endocrinol (Oxf). 2011;74:699-704 pubmed publisher
  19. McClung M, Miller P, Brown J, Zanchetta J, Bolognese M, Benhamou C, et al. Efficacy and safety of a novel delayed-release risedronate 35 mg once-a-week tablet. Osteoporos Int. 2012;23:267-76 pubmed publisher
    ..All three regimens were well tolerated. Risedronate 35 mg DR weekly is similar in efficacy and safety to risedronate 5 mg IR daily, and will allow patients to take their weekly risedronate dose immediately after breakfast. ..
  20. Watts N, Brown J, Cline G. Risedronate on 2 consecutive days a month reduced vertebral fracture risk at 1year compared with historical placebo. J Clin Densitom. 2010;13:56-62 pubmed publisher
    ..The use of appropriate historical control data may provide an alternative design to assess fracture effects in osteoporosis trials for which simultaneous placebo-controlled data are unavailable. ..
  21. Miller P, Delmas P, Lindsay R, Watts N, Luckey M, Adachi J, et al. Early responsiveness of women with osteoporosis to teriparatide after therapy with alendronate or risedronate. J Clin Endocrinol Metab. 2008;93:3785-93 pubmed publisher
    ..45). Teriparatide was well tolerated. This nonrandomized but prospective study suggests that there may be differences in anabolic responsiveness to teriparatide as a function of the type of prior bisphosphonate exposure. ..
  22. Shiraki M, Fukunaga M, Kushida K, Kishimoto H, Taketani Y, Minaguchi H, et al. A double-blind dose-ranging study of risedronate in Japanese patients with osteoporosis (a study by the Risedronate Late Phase II Research Group). Osteoporos Int. 2003;14:225-34 pubmed
    ..Based on these results, a once-daily dose of 2.5 mg of risedronate, which is half that used in Caucasians, is recommended for the treatment of involutional osteoporosis in Japanese patients. ..
  23. Im G, Qureshi S, Kenney J, Rubash H, Shanbhag A. Osteoblast proliferation and maturation by bisphosphonates. Biomaterials. 2004;25:4105-15 pubmed
    ..In summary, bisphosphonates, aside from their role as inhibitors of osteoclastic bone resorption, are promoters of osteoblast proliferation and maturation. ..
  24. Durchschlag E, Paschalis E, Zoehrer R, Roschger P, Fratzl P, Recker R, et al. Bone material properties in trabecular bone from human iliac crest biopsies after 3- and 5-year treatment with risedronate. J Bone Miner Res. 2006;21:1581-90 pubmed
    ..These changes at the material level of the bone matrix may contribute to risedronate's rapid and sustained antifracture efficacy in osteoporotic patients. ..
  25. Liepe K, Kropp J, Runge R, Kotzerke J. Therapeutic efficiency of rhenium-188-HEDP in human prostate cancer skeletal metastases. Br J Cancer. 2003;89:625-9 pubmed
    ..021 and 0.094). In conclusion, (188)Re-HEDP is an effective radiopharmaceutical used in the palliative treatment of metastatic bone pain in prostate cancer and shows minimal bone marrow toxicity. ..
  26. Brookhart M, Avorn J, Katz J, Finkelstein J, Arnold M, Polinski J, et al. Gaps in treatment among users of osteoporosis medications: the dynamics of noncompliance. Am J Med. 2007;120:251-6 pubmed
    ..Further research is needed to understand why patients often go for months without refilling prescriptions and also whether similar utilization patterns exist for other chronic medications. ..
  27. Kushida K, Fukunaga M, Kishimoto H, Shiraki M, Itabashi A, Inoue T, et al. A comparison of incidences of vertebral fracture in Japanese patients with involutional osteoporosis treated with risedronate and etidronate: a randomized, double-masked trial. J Bone Miner Metab. 2004;22:469-78 pubmed
    ..Daily oral risedronate (2.5 mg) was shown to provide an effective therapy for involutional osteoporosis in Japanese patients with good tolerability. ..
  28. Sorensen O, Crawford G, Mulder H, Hosking D, Gennari C, Mellstrom D, et al. Long-term efficacy of risedronate: a 5-year placebo-controlled clinical experience. Bone. 2003;32:120-6 pubmed
    ..3% (P < 0.001). This study demonstrates that the effects of risedronate over 3 years on vertebral fracture and BMD are maintained with a further 2 years of treatment. ..
  29. Zehnder M, Schmidlin P, Sener B, Waltimo T. Chelation in root canal therapy reconsidered. J Endod. 2005;31:817-20 pubmed
    ..STP was too weak a complexing agent to warrant further studies. Finally, CA-, EDTA-, and HEBP-NaOCl mixtures were evaluated for their antimicrobial capacity. Again, EDTA and CA negatively interfered with NaOCl, while HEBP did not. ..
  30. Eriksen E, Melsen F, Sod E, Barton I, Chines A. Effects of long-term risedronate on bone quality and bone turnover in women with postmenopausal osteoporosis. Bone. 2002;31:620-5 pubmed
  31. Chilibeck P, Davison K, Whiting S, Suzuki Y, Janzen C, Peloso P. The effect of strength training combined with bisphosphonate (etidronate) therapy on bone mineral, lean tissue, and fat mass in postmenopausal women. Can J Physiol Pharmacol. 2002;80:941-50 pubmed
    ..Strength training favourably affects body composition and muscular strength, which may be important for prevention of falls. ..
  32. Keen R, Jodar E, Iolascon G, Kruse H, Varbanov A, Mann B, et al. European women's preference for osteoporosis treatment: influence of clinical effectiveness and dosing frequency. Curr Med Res Opin. 2006;22:2375-81 pubmed
  33. Borah B, Dufresne T, Chmielewski P, Gross G, Prenger M, Phipps R. Risedronate preserves trabecular architecture and increases bone strength in vertebra of ovariectomized minipigs as measured by three-dimensional microcomputed tomography. J Bone Miner Res. 2002;17:1139-47 pubmed
    ..The study showed that risedronate preserved trabecular architecture in the vertebra of OVX minipigs, and that bone strength is tightly coupled to bone mass and architecture. ..
  34. Takada J, Iba K, Imoto K, Yamashita T. Changes in bone resorption markers among Japanese patients with postmenopausal osteoporosis treated with alendronate and risedronate. J Bone Miner Metab. 2007;25:142-6 pubmed
    ..In conclusion, alendronate decreases bone resorption markers more obviously and rapidly than risedronate, especially in high risk for fracture, but not significantly according to the guidelines of the Japan Osteoporosis Society. ..
  35. Watts N, Josse R, Hamdy R, Hughes R, Manhart M, Barton I, et al. Risedronate prevents new vertebral fractures in postmenopausal women at high risk. J Clin Endocrinol Metab. 2003;88:542-9 pubmed
    ..Significant reduction in fracture risk after 1 yr is an important benefit in patients at high risk for fracture because, without treatment, these patients are likely to sustain new fractures in the near term. ..
  36. Hasegawa J, Nagashima M, Yamamoto M, Nishijima T, Katsumata S, Yoshino S. Bone resorption and inflammatory inhibition efficacy of intermittent cyclical etidronate therapy in rheumatoid arthritis. J Rheumatol. 2003;30:474-9 pubmed
  37. Erben R, Mosekilde L, Thomsen J, Weber K, Stahr K, Leyshon A, et al. Prevention of bone loss in ovariectomized rats by combined treatment with risedronate and 1alpha,25-dihydroxyvitamin D3. J Bone Miner Res. 2002;17:1498-511 pubmed
    ..Therefore, this study in OVX rats suggests that combined therapy with bisphosphonates and vitamin D analogs may offer advantages over the treatment with bisphosphonates or vitamin D analogs alone. ..
  38. Hamilton B, McCoy K, Taggart H. Tolerability and compliance with risedronate in clinical practice. Osteoporos Int. 2003;14:259-62 pubmed
    ..The use of specialized osteoporosis nurses in clinics or primary care to follow up patients needs to be addressed. ..
  39. Taggart H, Bolognese M, Lindsay R, Ettinger M, Mulder H, Josse R, et al. Upper gastrointestinal tract safety of risedronate: a pooled analysis of 9 clinical trials. Mayo Clin Proc. 2002;77:262-70 pubmed
    ..The results of this extensive evaluation indicate that daily treatment with 5 mg of risedronate sodium is not associated with an increased frequency of adverse GI tract effects, even among patients at high risk for these events. ..
  40. Watts N, Worley K, Solis A, Doyle J, Sheer R. Comparison of risedronate to alendronate and calcitonin for early reduction of nonvertebral fracture risk: results from a managed care administrative claims database. J Manag Care Pharm. 2004;10:142-51 pubmed
    ..Risedronate was more effective than either calcitonin or alendronate in reducing the risk of nonvertebral fractures within 12 months of treatment. ..
  41. Yamaguchi K, Masuhara K, Yamasaki S, Nakai T, Fuji T. Cyclic therapy with etidronate has a therapeutic effect against local osteoporosis after cementless total hip arthroplasty. Bone. 2003;33:144-9 pubmed
    ..Further follow-up study with larger populations will be required to define the potential efficacy of intermittent cyclic etidronate therapy on postoperative bone loss. ..
  42. Dufresne T, Chmielewski P, Manhart M, Johnson T, Borah B. Risedronate preserves bone architecture in early postmenopausal women in 1 year as measured by three-dimensional microcomputed tomography. Calcif Tissue Int. 2003;73:423-32 pubmed
    ..Although there is no direct link in this study between fracture and preservation of architecture, it is reasonable to infer that the preservation of bone architecture may play a role in risedronate's anti-fracture efficacy. ..
  43. Sato S, Ohosone Y, Suwa A, Yasuoka H, Nojima T, Fujii T, et al. Effect of intermittent cyclical etidronate therapy on corticosteroid induced osteoporosis in Japanese patients with connective tissue disease: 3 year followup. J Rheumatol. 2003;30:2673-9 pubmed
    ..These results indicate that intermittent cyclical etidronate therapy is effective for the prevention and treatment of corticosteroid induced osteoporosis in patients with connective tissue diseases. ..
  44. Sato Y, Iwamoto J, Kanoko T, Satoh K. Risedronate therapy for prevention of hip fracture after stroke in elderly women. Neurology. 2005;64:811-6 pubmed
    ..4% in the risedronate group and increased by 35.8% in the placebo group. Treatment with risedronate increases bone mineral density in elderly women following an acute stroke and prevents hip fractures. ..
  45. Roelofs A, Hulley P, Meijer A, Ebetino F, Russell R, Shipman C. Selective inhibition of Rab prenylation by a phosphonocarboxylate analogue of risedronate induces apoptosis, but not S-phase arrest, in human myeloma cells. Int J Cancer. 2006;119:1254-61 pubmed
    ..In conclusion, our studies demonstrate that selective inhibition of Rab prenylation induces apoptosis, but not S-phase arrest, thus identifying distinct molecular pathways that mediate the antimyeloma effect of nitrogen-containing BPs. ..
  46. Zoehrer R, Roschger P, Paschalis E, Hofstaetter J, Durchschlag E, Fratzl P, et al. Effects of 3- and 5-year treatment with risedronate on bone mineralization density distribution in triple biopsies of the iliac crest in postmenopausal women. J Bone Miner Res. 2006;21:1106-12 pubmed
    ..These changes at the material level of the bone matrix may contribute to risedronate's antifracture efficacy in osteoporotic patients. ..
  47. Bingham C, Buckland Wright J, Garnero P, Cohen S, Dougados M, Adami S, et al. Risedronate decreases biochemical markers of cartilage degradation but does not decrease symptoms or slow radiographic progression in patients with medial compartment osteoarthritis of the knee: results of the two-year multinational knee osteoarthrit. Arthritis Rheum. 2006;54:3494-507 pubmed
    ..A sustained clinically relevant improvement in signs and symptoms was observed in all treatment and placebo groups. ..
  48. Gold D, Safi W, Trinh H. Patient preference and adherence: comparative US studies between two bisphosphonates, weekly risedronate and monthly ibandronate. Curr Med Res Opin. 2006;22:2383-91 pubmed
    ..However, patient compliance, persistence and adherence are complex, and methods to increase adherence beyond dosing schedules should be further investigated. ..
  49. Fratzl P, Roschger P, Fratzl Zelman N, Paschalis E, Phipps R, Klaushofer K. Evidence that treatment with risedronate in women with postmenopausal osteoporosis affects bone mineralization and bone volume. Calcif Tissue Int. 2007;81:73-80 pubmed
    ..This analysis also allows, for the first time, separation of the contributions of bone volume and matrix mineralization to the increase in BMD. ..
  50. Boonen S, McClung M, Eastell R, El Hajj Fuleihan G, Barton I, Delmas P. Safety and efficacy of risedronate in reducing fracture risk in osteoporotic women aged 80 and older: implications for the use of antiresorptive agents in the old and oldest old. J Am Geriatr Soc. 2004;52:1832-9 pubmed
    ..Because each therapeutic agent used for the treatment of osteoporosis may have unique characteristics, the observations made in this study should not be assumed to apply to other bisphosphonates. ..
  51. Follet H, Li J, Phipps R, Hui S, Condon K, Burr D. Risedronate and alendronate suppress osteocyte apoptosis following cyclic fatigue loading. Bone. 2007;40:1172-7 pubmed
    ..2) There was no difference between the effects of risedronate or alendronate on osteocyte apoptosis at these doses. ..