Bone Abstracts

There are few cases of pregnancy described in which the fetus was exposed to some bisphosphonates, but not ibandronate to our knowledge. Meanwhile, ibandronate has a high protein binding rate (87%) and short tissue’s half-life (24 days) and might be a less potentially harmful drug in the event of pregnancy.

A 23-year-old woman was admitted to our hospital with evident ACTH-dependent Cushing’s syndrome CS (24 h urinary free cortisol – 2413 nmol/24 h (reference range 59.2–413)). The etiological diagnosis was unclear. At the time of admission the patient had vertebral compressions of ThX, VII, V with a BMD loss −2.4 (Z-score) at the femur neck. After informed written consent was signed, the patient started treatment with ibandronic acid 3.0 intravenously every 3 months and a daily dose of ketokonasol 400–600 mg. The first injection was done on the 30th October 2009. The full remission of CS was achieved on 10th June 2010. Nevertheless, because of following severe adrenal insufficiency the patient received prednisolone 7.5–10 mg daily and continued the treatment with ibandronic acid with a total +11.9% L1–L4 and +6.8% proximal femur BMD increase. The final injection of ibandronic acid was performed on 28th April 2011. The pregnancy was diagnosed on 14th June 2011 at gestation age of 2–2.5 weeks. The pregnancy was normal with a caesarian section at the gestation age of 38 weeks. The child suffered from inspiratory insufficiency because of cord entanglement. A boy was born with a length of 49 cm and weight of 3120 g and without any signs of birth defects. The child was breastfed until 11 months of age. At the age of 1.5 years his height was 89 cm and his weight was 11 400 g. The child was healthy.

Conclusion: Treatment with ibandronate did not have any deleterious effects on the above mentioned pregnancy and fetus.