Effects of switching weekly alendronate or risedronate to monthly minodronate in patients with rheumatoid arthritis: a 12-month prospective study
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Switching weekly ALN or RIS to monthly MIN in patients with RA, of whom two-thirds were treated with low-dose PSL, significantly decreased bone turnover markers and increased BMD at 12 months, suggesting that monthly MIN may be an effective alternative treatment option of oral bisphosphonate treatment.
The aim of this prospective, observational study was to evaluate the effects of switching weekly alendronate (ALN 35 mg) or risedronate (RIS 17.5 mg) to monthly minodronate (MIN 50 mg) in patients with rheumatoid arthritis (RA).
Patient characteristics were as follows: n = 172; 155 postmenopausal women, age 65.5 (44–87) years; T-score of lumbar spine (LS), −1.4; total hip (TH), −1.8; femoral neck (FN), −2.1; dose and rate of oral prednisolone (2.3 mg/day), 69.1 %; prior duration of ALN or RIS, 46.6 months; were allocated, based on their preference, to either the (1) continue group (n = 88), (2) switch-from-ALN group (n = 44), or (3) switch-from-RIS group (n = 40).
After 12 months, increase in BMD was significantly greater in group 3 compared to group 1: LS (4.1 vs 1.2 %; P < 0.001), TH (1.9 vs −0.7 %; P < 0.01), and FN (2.7 vs −0.5 %; P < 0.05); and in group 2 compared to group 1: LS (3.2 vs 1.2 %; P < 0.05) and TH (1.5 vs −0.7 %; P < 0.01). The decrease in bone turnover markers was significantly greater in group 3 compared to group 1: TRACP-5b (−37.3 vs 2.5 %; P < 0.001), PINP (−24.7 vs −6.2 %; P < 0.05), and ucOC (−39.2 vs 13.0 %; P < 0.05); and in group 2 compared to group 1: TRACP-5b (−12.5 vs 2.5 %; P < 0.05) at 12 months.
Switching weekly ALN or RIS to monthly MIN in patients with RA may be an effective alternative treatment option of oral bisphosphonate treatment.
KeywordAlendronate Minodronate Osteoporosis Rheumatoid arthritis Risedronate
The authors thank Dr. Kenrin Shi for his excellent cooperation in conducting the study.
Compliance with ethical standards
This observational study was conducted in accordance with the ethical standards of the Declaration of Helsinki and was approved by ethical review boards at the clinical center (approval number 11273-2; Osaka University, Graduate School of Medicine). Written informed consent was obtained from individual patients included in the study.
Conflicts of interest
This research was funded by Astellas Pharma, Inc. The funder had no role in the study design, data collection, data analysis, decision to publish, or preparation of the manuscript. Kosuke Ebina, Takaaki Noguchi, Makoto Hirao, Jun Hashimoto, Shoichi Kaneshiro, Masao Yukioka, and Hideki Yoshikawa declare that they have no conflict of interest.
- 11.Dunford JE, Thompson K, Coxon FP, Luckman SP, Hahn FM, Poulter CD, Ebetino FH, Rogers MJ (2001) Structure-activity relationships for inhibition of farnesyl diphosphate synthase in vitro and inhibition of bone resorption in vivo by nitrogen-containing bisphosphonates. J Pharmacol Exp Ther 296:235–242PubMedGoogle Scholar
- 17.Matsui T, Kuga Y, Kaneko A, Nishino J, Eto Y, Chiba N, Yasuda M, Saisho K, Shimada K, Tohma S (2007) Disease activity score 28 (DAS28) using C-reactive protein underestimates disease activity and overestimates EULAR response criteria compared with DAS28 using erythrocyte sedimentation rate in a large observational cohort of rheumatoid arthritis patients in Japan. Ann Rheum Dis 66:1221–1226PubMedPubMedCentralCrossRefGoogle Scholar
- 18.Ebina K, Noguchi T, Hirao M, Kaneshiro S, Tsukamoto Y, Yoshikawa H (2015) Comparison of the effects of 12 months of monthly minodronate monotherapy and monthly minodronate combination therapy with vitamin K or eldecalcitol in patients with primary osteoporosis. J Bone Miner MetabGoogle Scholar
- 21.Ebina K, Hashimoto J, Shi K, Kashii M, Hirao M, Yoshikawa H (2014) Undercarboxylated osteocalcin may be an attractive marker of teriparatide treatment in RA patients: response to Mokuda. Osteoporos IntGoogle Scholar