Boston—Medications commonly used to treat postmenopausal osteoporosis might have an unexpected beneficial side effect: They also appear to be protective against pneumonia.

A report in the Journal of Bone and Mineral Research discloses that nitrogen-containing bisphosphonates (N-BPs) such as alendronate, are linked with lower risks of pneumonia, as well as pneumonia-related mortality.

To reach that conclusion, researchers from Beth Israel Deaconess Medical Center and Harvard Medical School, with colleagues from Hong Kong and elsewhere, focused on 4,041 patients with hip fractures who received N-BPs, compared with 11,802 patients who did not receive the treatment.

They found that, over a median follow-up time of 2.7 years, N-BPs were associated with a 24% lower risk of pneumonia compared with no treatment—69 versus 90 cases per 1,000 people per year. Based on that, the study team calculated an absolute risk difference of 0.02 and a number-needed- to-treat of 46.

Pneumonia mortality had a similar association, with a 35% lower risk associated with N-BPs—23 versus 35 per 1,000 patients per year for the N-BP and non-N-BP groups, respectively.

“When N‐BPs were compared with non‐N‐BP anti‐osteoporosis medications, the association remained significant. N‐BPs were associated with lower risks of pneumonia and pneumonia mortality,” the authors write. “Randomized controlled trials are now required to determine whether N‐BPs, non–vaccine‐based medications, can reduce pneumonia incidence in high risk groups.”

Researchers point out that previous animal studies determined that N-BP treatment leads to a high concentration of N-BPs in the respiratory tract. “Together with its anti-inflammatory and immune-modulatory properties, this may explain why N-BPs were associated with reduced risk of pneumonia, as revealed in our study,” explained senior author Ching-Lung Cheung, PhD, of The University of Hong Kong. 

Last year, research published in the Journal of Bone and Mineral Research pointed out that the drugs reduced the risk of premature mortality by 34% in a cohort of more than 6,000 patients. In that case, Australian researchers credited the reduction in early mortality risk as being significantly associated with a reduction in bone loss compared with no treatment.

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