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Therapie der Osteoporose mit Bisphosphonaten

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Osteoporose

Part of the book series: Praktische Orthopädie ((PRAKORTHO,volume 41))

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Zusammenfassung

Bisphosphonate sind synthetische Analoga des organischen Pyrophosphats, eines endogenen Regulators des Knochenumsatzes, der die Knochenresorption und mineralisation in vitro hemmt. Sie haben eine charakteristische P-C-P-Struktur, wobei an das C-Atom jeweils 2 verschiedene Seitenketten angebunden sind, welche für die spezifische Bindung bzw. die Wirkung der Bisphosphonate verantwortlich sind. Folgende Bisphosphonate sind derzeit bei klinischen Osteoporosestudien untersucht worden (in der Reihenfolge ihrer Potenz): Etidronat (Diphos, Didronel), Clodronat (Ostac), Pamidronat (Aredia), Alendronat (Fosamax), Risedronat (Actonel), Ibandronat (Bondronat) und Zoledronat (Zometa) u.a. Bisphosphonate hemmen die skelettale und extraskelettale Calzifikation und hemmen die osteoklastäre Knochenresorption (Wüster et al. 1997). Bei Etidronat kommen außerdem eine Hemmung der Mineralisation durch Hemmung des Kristallwachstums sowie eine osteoblasteninhibierende Wirkung hinzu, sodass Etidronat zyklisch dosiert werden muss. Abb. 1 zeigt eine aktuelle Version der derzeitig in klinischer Prüfung befindlichen oder zugelassenen Bisphosphonaten (Rodan et al. 2000).

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Literatur

  • Black DM, Thompson DE, Bauer DC, Ensrud K, Musliner T, Hochberg MC, Nevitt MC, Suryawanshi S, Cummings SR (2000) Fracture risk reduction with alendronate in women with osteoporosis: the Fracture Intervention Trial. FIT Research Group. J Clin Endocrinol Metab 85(11):4118–4124

    Article  CAS  Google Scholar 

  • Chesnut CH 3rd (1984) An appraisal of the role of estrogens in the treatment of postmenopausal osteoporosis. J Am Geriatr Soc 32(8):604–608.

    PubMed  Google Scholar 

  • Devogelaer JP (1996) Clinical use of bisphosphonates. Curr Opin Rheumatol 8(4):384–391

    Article  PubMed  CAS  Google Scholar 

  • Filipponi P, Pedetti M, Fedeli L, Cini L, Palumbo R, Boldrini S, Massoni C, Cristallini S (1995) Cyclical clodronate is effective in preventing postmenopausal bone loss: a comparative study with transcutaneous hormone replacement therapy. J Bone Miner Res 10(5):697–703

    Article  PubMed  CAS  Google Scholar 

  • Filipponi P, Cristallini S, Rizzello E, Policani G, Fedeli L, Gregorio F, Boldrini S, Troiani S, Massoni C (1996) Cyclical intravenous clodronate in postmenopausal osteoporosis: results of a long-term clinical trial. Bone 18(2):179–184

    Article  PubMed  CAS  Google Scholar 

  • Fogelman I, Ribot C, Smith R, Ethgen D, Sod E, Reginster JY (2000) Risedronate reverses bone loss in postmenopausal women with low bone mass: results from a multinational, double-blind, placebo-controlled trial. BMD-MN Study Group. J Clin Endocrinol Metab 85(5):1895–1900

    Article  PubMed  CAS  Google Scholar 

  • Gertz BJ, Holland SD, Kline WF, Matuszewski BK, Porras AG (1993) Clinical pharmacology of alendronate sodium. Osteoporos Int 3(Suppl 3):S13–16

    Article  Google Scholar 

  • Giannini S, D’Angelo A, Malvasi L, Castrignano R, Pati T, Tronca R, Liberto L, Nobile M, Crepaldi G (1993) Effects of one-year cyclical treatment with clodronate on postmenopausal bone loss. Bone 14(2):137–141

    Article  PubMed  CAS  Google Scholar 

  • Harris ST, Gertz BJ, Genant HK, Eyre DR, Survill TT, Ventura JN, DeBrock J, Ricerca E, Chesnut CH 3rd (1993) The effect of short term treatment with alendronate on vertebral density and biochemical markers of bone remodeling in early postmenopausal women. J Clin Endocrinol Metab 76(6):1399–14

    Article  PubMed  CAS  Google Scholar 

  • Harris ST, Watts NB, Jackson RD, Genant HK, Wasnich RD, Ross P, Miller PD, Licata AA, Chesnut CH 3rd (1993) Four-year study of intermittent cyclic etidronate treatment of postmenopausal osteoporosis: three years of blinded therapy followed by one year of open therapy. Am J Med 956):557–567

    Article  PubMed  CAS  Google Scholar 

  • Harris ST, Watts NB, Genant HK, McKeever CD, Hangartner T, Keller M, Chesnut CH 3rd, Brown J, Eriksen EF, Hoseyni MS, Axelrod DW, Miller PD (1999) Effects of risedronate treatment on vertebral and nonvertebral fractures in women with postmenopausal osteoporosis: a randomized controlled trial. Vertebral Efficacy With Risedronate Therapy (VERT) Study Group. JAMA 282(14):1344–1352

    Article  PubMed  CAS  Google Scholar 

  • Heaney RP, Saville PD (1976) Etidronate disodium in postmenopausal osteoporosis. Clin Pharmacol Ther 20(5):593–604

    PubMed  CAS  Google Scholar 

  • Hosking D, Chilvers CE, Christiansen C, Ravn P, Wasnich R, Ross P, McClung M, Balske A, Thompson D, Daley M, Yates AJ (1998) Prevention of bone loss with alendronate in postmenopausal women under 60 years of age. Early Postmenopausal Intervention Cohort Study Group. N Engl J Med 338(8):485–492

    Article  PubMed  CAS  Google Scholar 

  • Liberman UA, Weiss SR, Broil J, Minne HW, Quan H, Bell NH, Rodriguez-Portales J, Downs RW Jr, Dequeker J, Favus M (1995) Effect of oral alendronate on bone mineral density and the incidence of fractures in postmenopausal osteoporosis. The Alendronate Phase III Osteoporosis Treatment Study Group. N Engl J Med 333(22):1437–1443

    Article  PubMed  CAS  Google Scholar 

  • Lufkin EG, Argueta R, Whitaker MD, Cameron AL, Wong VH, Egan KS, O’Fallon WM, Riggs BL (1994) Pamidronate: an unrecognized problem in gastrointestinal tolerability. Osteoporos Int 4(6):320–322

    Article  PubMed  CAS  Google Scholar 

  • McClung MR, Geusens P, Miller PD, Zippel H, Bensen WG, Roux C, Adami S, Fogelman I, Diamond T, Eastell R, Meunier PJ, Reginster JY (2001) Effect of risedronate on the risk of hip fracture in elderly women. Hip Intervention Program Study Group. N Engl J Med 344(5):333–340

    Article  PubMed  CAS  Google Scholar 

  • Miller PD, Neal BJ, Mclntyre DO, Yanover MJ, Anger MS, Kowalski L (1991) Effect of cyclical therapy with phosphorus and etidronate on axial bone mineral density in postmenopausal osteoporotic women. Osteoporos Int 1(3):171–176

    Article  PubMed  CAS  Google Scholar 

  • Pacifici R, McMurtry C, Vered I, Rupich R, Avioli LV (1988) Coherence therapy does not prevent axial bone loss in osteoporotic women: a preliminary comparative study. J Clin Endocrinol Metab 66(4):747–753

    Article  PubMed  CAS  Google Scholar 

  • Pols HA, Felsenberg D, Hanley DA, Stepan J, Munoz-Torres M, Wilkin TJ, Qin-sheng G, Galich AM, Vandormael K, Yates AJ, Stych B (1999) Multinational, placebo-controlled, randomized trial of the effects of alendronate on bone density and fracture risk in postmenopausal women with low bone mass: results of the FOSIT study. Foxamax International Trial Study Group. Osteoporos Int 9(5):461–468

    Article  PubMed  CAS  Google Scholar 

  • Ravn P, Clemmesen B, Riis BJ, Christiansen C (1996) The effect on bone mass and bone markers of different doses of ibandronate: a new bisphosphonate for prevention and treatment of postmenopausal osteoporosis: a 1-year, randomized, doubleblind, placebo-controlled dose-finding study. Bone 19(5):527–533

    Article  PubMed  CAS  Google Scholar 

  • Reid DM, Hughes RA, Laan RF, Sacco-Gibson NA, Wenderoth DH, Adami S, Eusebio RA, Devogelaer JP (2000) Efficacy and safety of daily risedronate in the treatment of corticosteroid-induced osteoporosis in men and women: a randomized trial. European Corticosteroid-induced Osteoporosis Treatment Study. J Bone Miner Res 15(6):1006–1013

    Article  PubMed  CAS  Google Scholar 

  • Reid IR, Wattie DJ, Evans MC, Gamble GD, Stapleton JP, Cornish J (1994) Continuous therapy with Pamidronate, a potent bisphosphonate, in postmenopausal osteoporosis. J Clin Endocrinol Metab 79(6):1595–1599

    Article  PubMed  CAS  Google Scholar 

  • Reid IR, Brown JP, Burckhardt P, Horowitz Z, Richardson P, Trechsel U, Widmer A, Devogelaer JP, Kaufman JM, Jaeger P, Body JJ, Brandi ML, Broell J, Di Micco R, Genazzani AR, Felsenberg D, Happ J, Hooper MJ, Ittner J, Leb G, Mallmin H, Murray T, Ortolani S, Rubinacci A, Saaf M, Samsioe G, Verbruggen L, Meunier PJ (2002) Intravenous zoledronic acid in postmenopausal women with low bone mineral density. N Engl J Med 346(9):653–661

    Article  PubMed  CAS  Google Scholar 

  • Riis BJ, Ise J, von Stein T, Bagger Y, Christiansen C (2001) Ibandronate: a comparison of oral daily dosing versus intermittent dosing in postmenopausal osteoporosis. J Bone Miner Res 16(10):1871–1878

    Article  PubMed  CAS  Google Scholar 

  • Ringe JD (1996) Generalized osteoporosis in chronic polyarthritis — pathomechanisms and treatment approaches. Z Rheumatol 55(3):149–157

    PubMed  CAS  Google Scholar 

  • Rodan GA, Martin TJ (2000) Therapeutic approaches to bone diseases. Science 289(5484):1508–1514

    Article  PubMed  CAS  Google Scholar 

  • Saag KG, Emkey R, Schnitzer TJ, Brown JP, Hawkins F, Goemaere S, Thamsborg G, Liberman UA, Delmas PD, Malice MP, Czachur M, Daifotis AG (1998) Alendronate for the prevention and treatment of glucocorticoid-induced osteoporosis. Glucocorticoid-Induced Osteoporosis Intervention Study Group. N Engl J Med 339(5):292–299

    Article  PubMed  CAS  Google Scholar 

  • Sato M, Grasser W, Endo N, Akins R, Simmons H, Thompson DD, Golub E, Rodan GA (1991) Bisphosphonate action. Alendronate localization in rat bone and effects on osteoclast ultrastructure. J Clin Invest 88(6):2095–2105

    Article  PubMed  CAS  Google Scholar 

  • Smith ML, Fogelman I, Hart DM, Scott E, Bevan J, Leggate I (1989) Effect of etidronate disodium on bone turnover following surgical menopause. Calcif Tissue Int 44(2):74–79

    Article  PubMed  CAS  Google Scholar 

  • Storm T, Thamsborg G, Steiniche T, Genant HK, Sorensen OH (1990) Effect of intermittent cyclical etidronate therapy on bone mass and fracture rate in women with postmenopausal osteoporosis. N Engl J Med 322(18):1265–1271

    Article  PubMed  CAS  Google Scholar 

  • Storm T, Kollerup G, Thamsborg G, Genant HK, Sorensen OH (1996) Five years of clinical experience with intermittent cyclical etidronate for postmenopausal osteoporosis. J Rheumatol 23(9):1560–1564

    PubMed  CAS  Google Scholar 

  • Thomas T, Lafage MH, Alexandre C (1995) A typical osteomalacia after 2 year etidronate intermittent cyclic administration in osteoporosis. J Rheumatol 22(11):2183–2185

    PubMed  CAS  Google Scholar 

  • Valkema R, Vismans FJ, Papapoulos SE, Pauwels EK, Bijvoet OL (1989) Maintained improvement in calcium balance and bone mineral content in patients with osteoporosis treated with the bisphosphonate APD. Bone Miner 5(2):183–192

    Article  PubMed  CAS  Google Scholar 

  • Watts NB, Harris ST, Genant HK, Wasnich RD, Miller PD, Jackson RD, Licata AA, Ross P, Woodson GC 3rd, Yanover MJ, et al (1990) Intermittent cyclical etidronate treatment of postmenopausal osteoporosis. N Engl J Med 323(2):73–79

    Article  PubMed  CAS  Google Scholar 

  • Wüster C, Schoter KH, Thiebaud D, Manegold C, Krahl D, Clemens MR, Ghielmini M, Jaeger P, Scharia SH (1993) Methylpentylaminopropylidenebisphosphonate (BM 21.0955): a new potent and safe bisphosphonate for the treatment of cancer-associated hypercalcemia. Bone Miner 22(2):77–85

    Article  PubMed  Google Scholar 

  • Wüster C, Heilmann P (1997) Bisphosphonate therapy in osteoporosis. Inhibition of trabecular perforation by aminobisphosphonate. Fortschr Med 115(29):37-4

    Google Scholar 

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Authors
  1. Chr. Wüster
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  2. P. Hadji
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  3. W. Kneer
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Editors and Affiliations

  1. Klinik Fleetinsel, Admiralitätstr. 3, 20459, Hamburg, Deutschland

    Achim Hedtmann

  2. Albert-Schweitzer-Str. 9a, München-Unterhaching, Deutschland

    Siegfried Götte

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© 2002 Springer-Verlag Berlin Heidelberg

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Wüster, C., Hadji, P., Kneer, W. (2002). Therapie der Osteoporose mit Bisphosphonaten. In: Hedtmann, A., Götte, S. (eds) Osteoporose. Praktische Orthopädie, vol 41. Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-642-57442-9_14

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  • DOI: https://doi.org/10.1007/978-3-642-57442-9_14

  • Publisher Name: Steinkopff, Heidelberg

  • Print ISBN: 978-3-7985-1300-6

  • Online ISBN: 978-3-642-57442-9

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