Etidronic acid and steroid therapy: new indication. No proven impact on fractures.

(1) Etidronic acid (disodium etidronate) has a new licensed indication in the prevention of bone loss due to steroid therapy. (2) Three randomised, double-blind placebo-controlled trials have been done in this setting. The benefit of etidronic acid has been shown only on the basis of lumbar bone density (a surrogate end point) and only in women. (3) There is no concrete evidence that etidronic acid is any more effective than a placebo in reducing the risk of fracture in patients on steroid therapy. Similarly, in the absence of comparative trials there is no proof that etidronic acid is any more effective than hormone replacement therapy in postmenopausal women.