Current Osteoporosis Reports

, Volume 2, Issue 1, pp 24–30

Intravenous bisphosphonate therapy for osteoporosis: Where do we stand?

  • Henry G. Bone
  • Werner Schurr
Article

Abstract

The use of oral bisphosphonates, particularly members of the aminobisphosphonate subclass, is well established for the treatment of osteoporosis. In a number of clinical settings, intravenous administration appears to be advantageous. However, current dosing and efficacy data are limited while definitive, long-term trials with some of these agents are ongoing. In this article, we review the available information and discuss the use of these drugs on that basis.

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References and Recommended Reading

  1. 1.
    Fleisch H: Bisphosphonates in Bone Disease: from the Laboratory to the Patient. San Diego: Academic Press; 2000. This is a comprehensive and masterful monograph by one of the great figures in the bisphosphonate field.Google Scholar
  2. 2.
    Rezka AA, Rodan GA: Bisphosphonate mechanism of action.Curr Rheumatol Rep 2003, 5:65–74.Google Scholar
  3. 3.
    Porras AG, Holland SD, Gertz BJ:Pharmacokinetics of alendronate. Clin Pharmacol 1999, 36:315–328.CrossRefGoogle Scholar
  4. 4.
    Plotkin LI, Weinstein RS, Parfitt AM, et al.:Prevention of osteocytes and osteoblast apoptosis by bisphosphonates and calcitonin. J Clin Invest 1999, 104:1363–1374.PubMedCrossRefGoogle Scholar
  5. 5.
    Cranney A, Wells G, Willan A, et al.:Meta-analyses of therapies for postmenopausal osteoporosis. II. Meta-analysis of alendronate for the treatment of postmenopausal women. Endocr Rev 2002, 23:508–516.PubMedCrossRefGoogle Scholar
  6. 6.
    Cranney A, Tugwell P, Adachi J, et al.:Meta-analyses of therapies for postmenopausal osteoporosis. III. Metaanalysis of risedronate for the treatment of postmenopausal osteoporosis. Endocr Rev 2002, 23:517–523.PubMedCrossRefGoogle Scholar
  7. 7.
    Cranney A, Guyatt G, Griffith L, et al.:Meta-analyses of therapies for postmenopausal osteoporosis. IX: Summary of meta-analyses of therapies for postmenopausal osteoporosis. Endocr Rev 2002, 23:570–578.PubMedCrossRefGoogle Scholar
  8. 8.
    Hochberg MC, Greenspan S, Wasnich RD, et al.:Changes in bone density and turnover explain the reductions in incidence of nonvertebral fractures that occur during treatment with antiresorptive agents. J Clin Endocrinol Metab 2002, 87:1586–1592.PubMedCrossRefGoogle Scholar
  9. 9.
    Bone H, Hosking D, Devogelaer JP, et al.: For the Alendronate Phase III Osteoporosis Treatment Study Group; ten year experience with alendronate in the treatment of postmenopausal osteoporotic women. N Engl J Med, In press.Google Scholar
  10. 10.
    Garnero P, Sornay-Rendu E, Chapuy M-C, Delmas PD:Increased bone turnover in late postmenopausal women is a major determinant of osteoporosis. J Bone Miner Res 1996, 11:337–349.PubMedGoogle Scholar
  11. 11.
    Schnitzer T, Bone HG, Crepaldi G, et al.:Therapeutic equivalence of alendronate 70 mg once-weekly and alendronate 10 mg daily in the treatment of osteoporosis. Alendronate Once-Weekly Study Group. Aging (Milano) 2000, 12:1–12.Google Scholar
  12. 12.
    Brown JP, Kendler DL, McClung MR, et al.:The efficacy and tolerability of risedronate once a week for treatment of postmenopausal osteoporosis. Calcif Tissue Int 2002, 71:103–111.PubMedCrossRefGoogle Scholar
  13. 13.
    Christiansen C, Tanko LB, Warming L, et al.:Dose dependent effects on bone resorption and formation of intermittently administered intravenous ibandronate. Osteoporos Int 2003, 14:609–613.PubMedCrossRefGoogle Scholar
  14. 14.
    Chapurlat RD, Garnero P, Breart G, et al.:Serum type I collagen breakdown product (serum CTx) predicts hip fracture risk in elderly women: the EPIDOS study. Bone 2000, 27:283–286.PubMedCrossRefGoogle Scholar
  15. 15.
    Recker RR, Stakkestad JA, Felsenberg D, et al.:A new treatment paradigm: quarterly injections of ibandronate reduce the risk of fractures in women with postmenopausal osteoporosis (PMO): results of a 3-year trial [abstract 565]. Osteoporos Int 2000, 11(Suppl 2):5209.Google Scholar
  16. 16.
    Chapurlat RD, Delmas PD: Review of ibandronate in the treatment of osteoporosis. Expert Opin Pharmacother 2003, 4:391–396.PubMedCrossRefGoogle Scholar
  17. 17.
    Lipton A: Bone metastases in breast cancer. Curr Treat Options Oncol 2003, 4:15–18.Google Scholar
  18. 18.
    Michaelson MD, Smith MR: The role of bisphosphonates in the management of metastatic prostate cancer. Curr Oncol Rep 2003, 5:245–249.PubMedGoogle Scholar
  19. 19.
    Heidenreich A: Bisphosphonates in the management of metastatic prostate cancer. Oncology 2003, 65(Suppl 1):5–11.PubMedCrossRefGoogle Scholar
  20. 20.
    Hortobagyi GN: Novel approaches to the management of bone metastases. Semin Oncol 2003, 30(Suppl 16):161–166.PubMedCrossRefGoogle Scholar
  21. 21.
    Harousseau JL: Management of multiple myeloma. Rev Clin Exp Hematol 2002, 6:253–275.PubMedCrossRefGoogle Scholar
  22. 22.
    Lipton A, Small E, Saad F, et al.:The new bisphosphonate, Zometa (zoledronic acid), decreases skeletal complications in both osteolytic and osteoblastic lesions: a comparison to pamidronate. Cancer Invest 2002, 20(Suppl 2):45–54.PubMedCrossRefGoogle Scholar
  23. 23.
    Body JJ: Current and future directions in medical therapy: hypercalcemia. Cancer 2000, 15(Suppl 12):3054–3058.CrossRefGoogle Scholar
  24. 24.
    Reid IR, Wattie DJ, Evans MC, et al.:Continuous therapy with pamidronate, a potent bisphosphonate, in postmenopausal osteoporosis. J Clin Endocrinol Metab 1994, 79:1595–1599.PubMedCrossRefGoogle Scholar
  25. 25.
    Brumsen C, Papapoulos S, Lips P, et al.:Daily oral pamidronate in women and men with osteoporosis: a 3-year randomized placebo-controlled clinical trial with a 2-year open extension. J Bone Miner Res 2002, 17:1057–1064.PubMedCrossRefGoogle Scholar
  26. 26.
    Delmas PD, Recker, RR, Stakkestad JA, et al.: Oral ibandronate significantly reduces fracture risk in postmenopausal osteoporosis when administered daily or with a unique drug-free interval: results from a pivotal phase III study [abstract 037]. Osteoporos Int 2002 13(Suppl 1):S15.Google Scholar
  27. 27.
    Machado CE, Flombaum CD: Safety of pamidronate in patients with renal failure and hypercalcemia. Clin Nephrol 1996, 45:175–179.PubMedGoogle Scholar
  28. 28.
    Banerjee D, Asif A, Striker L, et al.:Short-term, high-dose pamidronate-induced acute tubular necrosis: the postulated mechanisms of bisphosphonate nephrotoxicity. Am J Kidney Dis 2003, 41:E18.PubMedCrossRefGoogle Scholar
  29. 29.
    Alden CL, Burns JL, Parker RD, et al.:Characterization of the early ultrastructural and biochemical events occurring in dichloromethane diphosphonate nephrotoxicity. Toxicol Pathol 1990, 18:661–666.PubMedGoogle Scholar
  30. 30.
    Markowtiz GS, Fine PL, Stack JI, et al.:Toxic acute tubular necrosis following treatment with zoledronate (Zometa). Kidney Int 2003, 64:281–289.CrossRefGoogle Scholar
  31. 31.
    Chang JT, Green L, Beitz J: Renal failure with the use of zoledronic acid. N Engl J Med 2003, 347:1676–1678.CrossRefGoogle Scholar
  32. 32.
    Tarassoff P, Hei YJ, Maladorno D: Renal failure with the use of zoledronic acid. N Engl J Med 2003, 347:1678–1679.Google Scholar
  33. 33.
    Thiebaud D, Burckhardt P, Melchior J, et al.:Two years’ effectiveness of intravenous pamidronate (APD) versus oral fluoride for osteoporosis occurring in the postmenopause. Osteoporos Int 1994, 4:76–83.PubMedCrossRefGoogle Scholar
  34. 34.
    Peretz A, Body JJ, Dumon JC, et al.:Cyclical pamidronate infusions in postmenopausal osteoporosis. Maturitas 1996, 25:69–75.PubMedCrossRefGoogle Scholar
  35. 35.
    Sarli M, Fradinger E, Morillo S, et al.:Treatment of post menopausal osteoporosis with intravenous pamidronate in patients with esophagogastric pathology [in Spanish]. Medicina 1998, 58:446–452.PubMedGoogle Scholar
  36. 36.
    Guttmann G, Van Linthoudt D: Efficacy of intravenous pamidronate in osteoporosis, mineralometric evaluation [in French]. Schweiz Rundsch Med Prax 1999 88:2057–2060.PubMedGoogle Scholar
  37. 37.
    Bianda T, Linka A, Junga G, Brunner H, et al.:Prevention of osteoporosis in heart transplant recipients: a comparison of calcitriol with calcitonin and pamidronate. Calcif Tissue Int 2002, 67:116–121.CrossRefGoogle Scholar
  38. 38.
    Boutsen Y, Jamart J, Esselinckx W, Devogelaer JP: Primary prevention of glucocorticoid-induced osteoporosis with intravenous pamidronate and calcium: a prospective controlled 1-year study comparing a single infusion, an infusion given once every 3 months, and calcium alone. J Bone Miner Res 2001, 16:104–112.PubMedCrossRefGoogle Scholar
  39. 39.
    Caldeari F, Burckhardt P: Treatment of osteoporosis with intravenous pamidronate: a retrospective analysis [abstract F336]. J Bone Miner Res 1999 14:5276.Google Scholar
  40. 40.
    Reeves HL, Francis RM, Manas DM, et al.:Intravenous bisphosphonate prevents symptomatic osteoporotic vertebral collapse in patients after liver transplantation. Liver Transpl Surg 1998, 4:404–409.PubMedCrossRefGoogle Scholar
  41. 41.
    Shane E, Rodino MA, McMahon DJ, et al.:Prevention of bone loss after heart transplantation with antiresorptive therapy: a pilot study. J Heart Lung Transplant 1998 17:1089–1096.PubMedGoogle Scholar
  42. 42.
    Aris RM, Lester GE, Renner JB, et al.:Efficacy of pamidronate for osteoporosis in patients with cystic fibrosis following lung transplantation. Am J Respir Crit Care Med 2000, 162:941–946.PubMedGoogle Scholar
  43. 43.
    Krieg MA, Seydoux C, Sandini L, et al.:Intravenous pamidronate as treatment for osteoporosis after heart transplantation: a prospective study. Osteoporos Int 2001, 12:112–116.PubMedCrossRefGoogle Scholar
  44. 44.
    Dodidou P, Bruckner T, Hosch S, et al.:Better late than never? Experience with intravenous pamidronate treatment in patients with low bone mass or fractures following cardiac or liver transplantation. Osteoporos Int 2003, 14:82–89.PubMedCrossRefGoogle Scholar
  45. 45.
    Diamond TH, Winters J, Smith A, et al.:The antiosteoporotic efficacy of intravenous pamidronate in men with prostate carcinoma receiving combined androgen blockade: a double blind, randomized, placebo-controlled crossover study. Cancer 2001, 92:1444–1450.PubMedCrossRefGoogle Scholar
  46. 46.
    Smith MR: Diagnosis and management of treatment-related osteoporosis in men with prostate carcinoma. Cancer 2003, 97:789–795.PubMedCrossRefGoogle Scholar
  47. 47.
    Shaw NJ, Boivin CM, Crabtree NJ: Intravenous pamidronate in juvenile osteoporosis. Arch Dis Child 2000, 83:143–145.PubMedCrossRefGoogle Scholar
  48. 48.
    Brumsen C, Hamdy NA, Papapoulos SE: Long-term effects of bisphosphonates on the growing skeleton. Studies of young patients with severe osteoporosis. Medicine (Baltimore) 1997, 76:266–283.CrossRefGoogle Scholar
  49. 49.
    Gandrud LM, Cheung JC, Daniels MW, Bachrach LK: Low-dose intravenous pamidronate reduces fractures in childhood osteoporosis. J Pediatr Endocinol Metab 2003, 16:887–892.Google Scholar
  50. 50.
    Steelman J, Zeitler P: Treatment of symptomatic pediatric osteoporosis with cyclic single-day intravenous pamidronate infusions. J Pediatr 2003, 142:417–423.PubMedCrossRefGoogle Scholar
  51. 51.
    Kanumakala S, Boneh A, Zacharin M: Pamidronate treatment improves bone mineral density in children with Menkes disease. J Inherit Metab Dis 2002, 25:391–398.PubMedCrossRefGoogle Scholar
  52. 52.
    Glorieux FH, Rauch F, Shapiro JR: Bisphosphonates in children with bone diseases. N Engl J Med 2003, 20:2068–2071. The authors most experienced in the use of bisphosphonates in pediatric disorders, especially osteogenesis imperfecta.Google Scholar
  53. 53.
    Varenna M, Zucchi F, Binelli L, et al.:Intravenous pamidronate in the treatment of transient osteoporosis of the hip. Bone 2002, 31:96–101.PubMedCrossRefGoogle Scholar
  54. 54.
    Schapira D, Braun Moscovici Y, Gutierrez G, Nahir AM:Severe transient osteoporosis of the hip during pregnancy. Successful treatment with intravenous bisphosphonates. Clin Exp Rheumatol 2003, 21:107–110.PubMedGoogle Scholar
  55. 55.
    Passeri M, Baroni MC, Pedrazzoni M, et al.:Intermittent treatment with intravenous 4-amino-1-hydroxybutylidene-1,1-bisphosphonate (AHBuBP) in the therapy of postmenopausal osteoporosis. Bone Miner 1991, 15:237–247.PubMedCrossRefGoogle Scholar
  56. 56.
    Khan SA, Kanis JA, Vasikaran S, et al.:Elimination and biochemical responses to intravenous alendronate in postmenopausal osteoporosis. J Bone Miner Res 1997, 12:1700–1707.PubMedCrossRefGoogle Scholar
  57. 57.
    Thiebaud D, Burckhardt P, Kriegbaum H, et al.:Three monthly intravenous injections of ibandronate in the treatment of postmenopausal osteoporosis. Am J Med 1997, 103:298–307.PubMedCrossRefGoogle Scholar
  58. 58.
    Black D, Thompson DE, Bauer DC, et al.:Fracture risk reduction with alendronate in women with osteoporosis. FIT Research Group. J Clin Endrocrinol Metab 2000, 85:4118–4124.CrossRefGoogle Scholar
  59. 59.
    McClung MF, Geusens P, Miller PD, et al.:Effect of risedronate on the risk of hip fracture in elderly women. Hip Intervention Study Group. N Engl J Med 2001, 344:333–340.PubMedCrossRefGoogle Scholar
  60. 60.
    Ringe JD, Dorst A, Faber H, et al.:Intermittent intravenous ibandronate injections reduce vertebral fracture risk in corticosteroid-induced osteoporosis: results from a longterm comparative study. Osteoporos Int 2003, 14:801–807.PubMedCrossRefGoogle Scholar
  61. 61.
    Buckler H, Fraser W, Hosking D, et al.:Single infusion of zoledronate in Paget’s disease of bone: a placebocontrolled, dose-ranging study. Bone 1999, 24:81S-85S.PubMedCrossRefGoogle Scholar
  62. 62.
    Reid IR, Brown JP, Burckhardt P, et al.:Intravenous zoledron acid in postmenopausal women with low bone mineral density. N Engl J Med 2002, 346:653–661. This is the best current information about a drug that may permit a once-a-year intravenous dose.PubMedCrossRefGoogle Scholar
  63. 63.
    Filipponi P, Pedetti M, Fedeli L, et al.: Cyclical clodronate is effective in preventing postmenopausal bone loss: a comparative study with transcutaneous hormone replacement therapy. J Bone Miner Res 1995, 10:697–703.PubMedCrossRefGoogle Scholar
  64. 64.
    Heikkinen JE, Selander KS, Laitinen K, et al.:Short-term intravenous bisphosphonates in prevention of postmenopausal bone loss. J Bone Miner Res 1997, 12:103–110.PubMedCrossRefGoogle Scholar
  65. 65.
    Haderslev KV, Tjellesen L, Sorensen HA, Staun M: Effect of cyclical intravenous clodronate therapy on bone mineral density and markers of bone turnover in patients receiving home parenteral nutrition. Am J Clin Nutr 2002, 76:482–488.PubMedGoogle Scholar
  66. 66.
    Braga V, Gatti D, Colapietro F, et al.:Intravenous intermittent neridronate in the treatment of postmenopausal osteoporosis. Bone 2003, 33:342–345.PubMedCrossRefGoogle Scholar
  67. 67.
    Epstein S, Inzerillo A, Caminis J, Zaidi M: Disorders associated with acute rapid and severe bone loss. J Bone Miner Res 2003, 18:2083–2094.PubMedCrossRefGoogle Scholar

Copyright information

© Current Science Inc. 2004

Authors and Affiliations

  • Henry G. Bone
    • 1
  • Werner Schurr
  1. 1.Michigan Bone and Mineral ClinicDetroitUSA

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