Risedronate prevents hip fractures, but who should get therapy?

The Hip Intervention Program (HIP) trial establishes that risedronate (Actonel) prevents hip fracture in elderly women with osteoporosis. However, the drug had no statistically significant effect on hip fracture risk in elderly women in whom bone density status was not known. Patients should be selected for bisphosphonate therapy on the basis of low bone density. A history of vertebral fractures increases the risk for hip fractures.