Elsevier

Bone

Volume 42, Supplement 1, March 2008, Pages S54-S55
Bone

Potential excessive suppression of bone turnover with long-term oral bisphosphonates therapy in postmenopausal osteoporotic patients (prospective study monitored with biochemical marker of bone turnover)

https://doi.org/10.1016/j.bone.2007.12.093Get rights and content

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Background of Data

Bisphosphonates (BP) decrease bone resorption and remodeling (bone formation). The excessive and prolonged suppression of bone turnover results in the poor bone quality on the treatment of osteoporosis whereas the relevant pharmacological benefits of BP are widely known. Concerns have been raised about potential excessive suppression of bone turnover during long-term use. BP carry the potential risk of excessively suppressing bone turnover that can impair some of the biomechanical properties of

Objectives

The aim of this study is to clarify the effects of BP on bone resorption and also on bone formation through long-term oral BP therapy using urine cross-linked N-telopeptides of type 1 collagen (u-NTx) and bone-specific alkaline phosphatase (BAP).

Patients and Methods

Eighty-four Japanese postmenopausal patients were enrolled in this study. All patients were treated with oral BP once a day before breakfast. Then medications were continued for 24 months unless adverse events occurred. Alendronates (ALN) were randomizedly prescribed for 41 patients and Risedronates (RIS) were for 43 patients (N.S.). The u-NTx was measured at baseline, 6 months, 12 months, 18 months and 24 months with morning second void urine samples. At the 24th month laboratory assessment

Results

The excessively low u-NTx (lower than 10 nmolBCE/mmol·Cr) was observed in 4 of 84 patients (4.8%). The value of BAP under the standard range was observed in 9.4% (5/53 patients) at the 24-month follow up (4/23 patients of ALN and 1/30 patients of RIS; p < 0.1,chi-squre). There was a trend in the occurrence of the lower deviation in ALN from the standard range of BAP.

Conclusion

We suggest that the awareness and monitoring for the potential development of excessive suppression not only in bone resorption but also bone formation are required in the long-tem BS therapy.

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