Long-term treatment of osteoporotic women with bisphosphonates does not impair the response to subsequently administered intravenous pamidronate

• Published in: Osteoporosis international 2013-08, Vol.24 (8), p.2353-2357
• Main Authors: Yavropoulou, M. P., Hamdy, N. A. T., Papapoulos, S. E.
• Format: Article
• Language: English
• Subjects: Administration, Oral; Adult; Aged; Biomarkers - blood; Bone Density - drug effects; Bone Density Conservation Agents - administration & dosage; Bone Density Conservation Agents - therapeutic use; Collagen Type I - blood; Diphosphonates - administration & dosage; Diphosphonates - therapeutic use; Drug Administration Schedule; Drug Substitution; Drug therapy; Endocrinology; Female; Glucocorticoids - adverse effects; Humans; Infusions, Intravenous; Long term health care; Medicine; Medicine & Public Health; Middle Aged; Orthopedics; Osteoporosis; Osteoporosis - blood; Osteoporosis - chemically induced; Osteoporosis - drug therapy; Osteoporosis - physiopathology; Osteoporosis, Postmenopausal - blood; Osteoporosis, Postmenopausal - drug therapy; Osteoporosis, Postmenopausal - physiopathology; Peptide Fragments - blood; Peptides - blood; Procollagen - blood; Rheumatology; Short Communication; Treatment Outcome; Womens health
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-013-2301-1

Summary We addressed the question whether the response of osteoporotic patients to bisphosphonate treatment is reduced with time. Bisphosphonate-treated women with postmenopausal or glucocorticoid-induced osteoporosis showed adequate and consistent changes of bone markers to subsequently administered intravenous pamidronate. Response of osteoporotic patients to bisphosphonates is not impaired during their long-term administration. Introduction Inadequate response to bisphosphonate treatment has been described in patients with Paget’s disease of bone but has not been addressed in osteoporosis although treatment failure is a clinically relevant problem. Methods Twenty one women with postmenopausal osteoporosis (PMO) aged 68 ± 8.2 years and 14 women with glucocorticoid-induced osteoporosis (GIOP) aged 65 ± 10 years were treated with tri-monthly intravenous infusions of 45 mg of pamidronate for 1 year. All patients had been previously treated with bisphosphonates (alendronate, risedronate, pamidronate) for a mean period of 6.2 years (range, 1.3–14 years). Blood samples were taken for measurement of the bone resorption marker C-terminal crosslinking telopeptide of type I collagen (CTX-I) on days 1 and 4 and of the bone formation marker procollagen type I N propeptide, (P1NP) on day 1 of every tri-monthly treatment course. Results With each treatment course there was a significant decrease in serum CTX-I on day 4 and an increase to baseline values 3 months after each infusion in both PMO (mean values, day 1: 291.33 ± 160.78 pg/ml vs. day 4: 131 ± 91.7 pg/ml, p