Do Bisphosphonates remain basic drugs for the treatment of osteoporosis?

Lali Kilasonia; Luba Lagvilava; Nana Kirvalidze; Medea Kopaliani; Neriman Tsartsidze

doi:10.1530/boneabs.1.PP402

Introduction: If we pay more attention, we will notice that the frequency of drugs against osteoporosis is increasing on world markets every year. At the same time, there is ongoing compromises on medicines, targeted activity mechanisms of new drugs are not fully studies. To be short, recent knowledge gives use impression that only Bisphosphonates maintain their strong positions if the medicines and most importantly, the length of treatment is adequately selected.

Materials and methods: We would like to share our experience on the results and effectiveness of treatment of 500 patients. 300 out of these 500 patients were receiving Peroral Bonviva injections for 3 years, while 150 patients were receiving Bonviva i.v. also for 3 years. In parallel to Bonviva, each patient in these two groups was receiving combined preparation of Ca and D₃ vitamins. Patients were aged between 35–85.3 age categories were identified: Group I – 175 patients aged 35–50; Group II – 200 patients aged 51–75; Group III – 125 patients aged 75–85. Gender: 110 male and 390 female patients. Patients were divided into the following categories by their clinical forms of osteoporosis: 135 women with post menopausal diagnosis; 75 patients- with rheumatoid arthritis; 65 patients- with male osteoporosis; 116 patients with thyroidal osteoporosis; 18 patients- with osteoporosis during osteoarthritis; 31 patients with senile osteoporosis.

Results: Treatment effect of Bonviva after 3 year treatment reaches 60–70% notwithstanding the age of the patients and clinical form of the disease. Fracture risks in spinal ribs have decreased by 34 ad by 39% in peripheral bones after 3 year treatment with peroral Bonviva. Maximal index of decreasing fracture risks was identified in lumbar vertebrae, reaching 44% as a result of 3 year Bonviva intra-vein treatment. This one again proves that clinical effects of Bisphosphonates are likely to be related to its cumulative level in the bone rather than the frequency of its administration. Clinical effects of Bonviva in older ages (Group II) is less, which, in parallel to antiresorptive effect, should be related the lack of formation in the age, causing difficulties to Bisphosphinates.

Table 1 Increase of BMD as a result of Bonviva treatment during different clinical forms of osteoporosis 3 year experience.
Peroral Ibandronate (monthly 150 mg)
Number of patients	Post menopausal osteoporosis	Osteoarthritis + osteoporosis	Thyroidal osteoporosis	Male	Rheumatoid	Senile
Nn=350	≥5.4%	≥5.8%	≥6.1%	≥5.1%	≥6.8%	≥5.2%
Intra-vein Ibandronate (3 mg- once every 3 month)
Number of patients	Post menopausal osteoporosis	Osteoarthritis + osteoporosis	Thyroidal osteoporosis	Male	Rheumatoid	Senile
Nn=150	≥5.8%	≥6.3%	≥6.3%	≥6.4%	≥7.1%	≥5.5%

Bone Abstracts

PP402