Efficacy of intravenously administered ibandronate in postmenopausal Korean women with insufficient response to orally administered bisphosphonates

• Published in: Journal of bone and mineral metabolism Vol. 30; no. 5; pp. 588 - 595
• Main Authors: Bae, Sung Jin, Kim, Beom-Jun, Lim, Kyeong Hye, Lee, Seung Hun, Kim, Hong Kyu, Kim, Ghi Su, Koh, Jung-Min
• Format: Journal Article
• Language: English
• Published: Japan Springer Japan 01.09.2012; Springer; Springer Nature B.V
• Subjects: Administration, Intravenous; Administration, Oral; Aged; Aged, 80 and over; Alendronate - administration & dosage; Asian Continental Ancestry Group; Biological and medical sciences; Bone Density - drug effects; Bone Density Conservation Agents - administration & dosage; Bones, joints and connective tissue. Antiinflammatory agents; Collagen Type I - blood; Diphosphonates - administration & dosage; Diseases of the osteoarticular system; Etidronic Acid - analogs & derivatives; Etidronic Acid - therapeutic use; Female; Humans; Injections, Intravenous; Longitudinal Studies; Lumbar Vertebrae - drug effects; Medical sciences; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Original Article; Orthopedics; Osteoporosis, Postmenopausal - blood; Osteoporosis, Postmenopausal - drug therapy; Osteoporosis. Osteomalacia. Paget disease; Peptides - blood; Pharmacology. Drug treatments; Postmenopause - blood; Retrospective Studies; Risedronate Sodium; Osteoporosis; Bisphosphonates; Insufficient response; C-telopeptide; Human; Antiosteoporotic; Intravenous administration; Diseases of the osteoarticular system; Rheumatology; Oral administration; Ibandronic acid; Korean; Antiosteoclastic agent; Postmenopause; Woman
• ISSN: 0914-8779; 1435-5604
• DOI: 10.1007/s00774-012-0361-5

We investigated rates of insufficient and over-responsiveness to orally administered bisphosphonates in postmenopausal women, and tested the efficacy of intravenous ibandronate in patients with insufficient response to orally administered bisphosphonates. Postmenopausal women were treated with either alendronate (70 mg/week; n  = 88) or risedronate (35 mg/week; n  = 84) for 1 year, and their response to orally administered bisphosphonates was assessed using serum C-telopeptide (CTX) levels. Insufficient responders were changed to once-quarterly intravenous ibandronate 3 mg injection ( n  = 13) or maintained on orally administered bisphosphonates ( n  = 19), according to patients’ preference, for an additional 1 year. There was no significant difference in baseline characteristics between two orally administered bisphosphonate groups except the bone mineral density values at the lumbar spine. Insufficient rate was higher in the risedronate group (19.0 %) than in the alendronate group (8.0 %), using the premenopausal serum CTX median as a cut-off ( P  = 0.043). The over-response rate among the alendronate group (59.1 %) was significantly higher than that in the risedronate group (38.1 %), based on a serum CTX cut-off value of 0.100 ng/ml ( P  = 0.006). Intravenous ibandronate suppressed serum CTX levels to a significantly greater degree at 7 days after the second dosing (0.191 ± 0.110 ng/mL; P  < 0.001) and 3 months after the fourth dosing (0.274 ± 0.159 ng/mL; P  = 0.004) among insufficient responders, compared with post-oral/pre-intravenous levels (0.450 ± 0.134 ng/mL). Rates of insufficient and over-responsiveness to orally administered bisphosphonates were considerable, and a change to intravenous bisphosphonates may be considered in patients showing an insufficient response to orally administered bisphosphonates.