Osteoporosis International

, Volume 16, Issue 12, pp 2063–2068 | Cite as

Effective and rapid treatment of painful localized transient osteoporosis (bone marrow edema) with intravenous ibandronate

  • J. D. RingeEmail author
  • A. Dorst
  • H. Faber
Original Article


Localized transient osteoporosis (LTO; bone marrow edema syndrome) is a rare disorder of generally unknown etiology that is characterized by acute onset of disabling bone pain. Treatment options are currently limited and largely ineffective. The locally increased bone turnover and low bone mineral density (BMD) typical of LTO indicate a potential role for bisphosphonate therapy. Ibandronate, a potent nitrogen-containing bisphosphonate, has proven efficacy in the management of postmenopausal osteoporosis and corticosteroid-induced osteoporosis when administered as a convenient intermittent intravenous (IV) injection with a between-dose interval of 2 or 3 months. In a study of 12 patients with LTO, ibandronate was administered as an initial 4-mg IV dose with a second, optional injection of 2 mg at 3 months. Daily calcium and vitamin D supplements were provided. Pain was measured at baseline and at 1, 2, 3, and 6 months using a visual analog scale (VAS) of 1–10, and BMD was measured at baseline and 6 months. IV ibandronate provided rapid and substantial pain relief. The mean (SD) VAS score decreased from 8.4 (1.3) at baseline to 0.5 (0.7) at 6 months, at which time seven patients had achieved complete pain relief. At 6 months, mean lumbar spine BMD had increased by 4.0% (range –0.8 to 7.7%) in the overall population. IV ibandronate injection affords advantages over currently available oral and IV bisphosphonates and thus offers a promising therapeutic advance in the treatment of LTO.


Bisphosphonate Bone marrow edema Ibandronate Intravenous Transient osteoporosis 


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2005

Authors and Affiliations

  1. 1.Medizinische Klinik IVKlinikum Leverkusen, University of CologneLeverkusenGermany

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