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.
Similar content being viewed by others
References and Recommended Reading
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.
Rezka AA, Rodan GA: Bisphosphonate mechanism of action.Curr Rheumatol Rep 2003, 5:65–74.
Porras AG, Holland SD, Gertz BJ:Pharmacokinetics of alendronate. Clin Pharmacol 1999, 36:315–328.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Chapurlat RD, Delmas PD: Review of ibandronate in the treatment of osteoporosis. Expert Opin Pharmacother 2003, 4:391–396.
Lipton A: Bone metastases in breast cancer. Curr Treat Options Oncol 2003, 4:15–18.
Michaelson MD, Smith MR: The role of bisphosphonates in the management of metastatic prostate cancer. Curr Oncol Rep 2003, 5:245–249.
Heidenreich A: Bisphosphonates in the management of metastatic prostate cancer. Oncology 2003, 65(Suppl 1):5–11.
Hortobagyi GN: Novel approaches to the management of bone metastases. Semin Oncol 2003, 30(Suppl 16):161–166.
Harousseau JL: Management of multiple myeloma. Rev Clin Exp Hematol 2002, 6:253–275.
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.
Body JJ: Current and future directions in medical therapy: hypercalcemia. Cancer 2000, 15(Suppl 12):3054–3058.
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.
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.
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.
Machado CE, Flombaum CD: Safety of pamidronate in patients with renal failure and hypercalcemia. Clin Nephrol 1996, 45:175–179.
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.
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.
Markowtiz GS, Fine PL, Stack JI, et al.:Toxic acute tubular necrosis following treatment with zoledronate (Zometa). Kidney Int 2003, 64:281–289.
Chang JT, Green L, Beitz J: Renal failure with the use of zoledronic acid. N Engl J Med 2003, 347:1676–1678.
Tarassoff P, Hei YJ, Maladorno D: Renal failure with the use of zoledronic acid. N Engl J Med 2003, 347:1678–1679.
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.
Peretz A, Body JJ, Dumon JC, et al.:Cyclical pamidronate infusions in postmenopausal osteoporosis. Maturitas 1996, 25:69–75.
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.
Guttmann G, Van Linthoudt D: Efficacy of intravenous pamidronate in osteoporosis, mineralometric evaluation [in French]. Schweiz Rundsch Med Prax 1999 88:2057–2060.
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.
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.
Caldeari F, Burckhardt P: Treatment of osteoporosis with intravenous pamidronate: a retrospective analysis [abstract F336]. J Bone Miner Res 1999 14:5276.
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.
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.
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.
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.
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.
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.
Smith MR: Diagnosis and management of treatment-related osteoporosis in men with prostate carcinoma. Cancer 2003, 97:789–795.
Shaw NJ, Boivin CM, Crabtree NJ: Intravenous pamidronate in juvenile osteoporosis. Arch Dis Child 2000, 83:143–145.
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.
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.
Steelman J, Zeitler P: Treatment of symptomatic pediatric osteoporosis with cyclic single-day intravenous pamidronate infusions. J Pediatr 2003, 142:417–423.
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.
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.
Varenna M, Zucchi F, Binelli L, et al.:Intravenous pamidronate in the treatment of transient osteoporosis of the hip. Bone 2002, 31:96–101.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Braga V, Gatti D, Colapietro F, et al.:Intravenous intermittent neridronate in the treatment of postmenopausal osteoporosis. Bone 2003, 33:342–345.
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.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Bone, H.G., Schurr, W. Intravenous bisphosphonate therapy for osteoporosis: Where do we stand?. Curr Osteoporos Rep 2, 24–30 (2004). https://doi.org/10.1007/s11914-004-0011-5
Issue Date:
DOI: https://doi.org/10.1007/s11914-004-0011-5