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New Progress in Improving the Delivery Methods of Bisphosphonates in the Treatment of Bone Tumors.

Bone tumors are tumors that occur in the bone or its accessory tissues, including primary tumors and metastatic tumors. The main mechanism of bisphosphonate is to inhibit the resorption of destructive bone, inhibit the activity of osteoclasts and reduce the concentration of blood calcium. Therefore, bisphosphonates can be used for malignant hypercalcaemia, pain caused by osteolytic bone metastasis, prevention of osteolytic bone metastasis, multiple myeloma osteopathy, improving radiosensitivity and so on. However, the traditional administration of bisphosphonates can cause a series of adverse

Definition and management of very high fracture risk in women with postmenopausal osteoporosis: a position statement from the Brazilian Society of Endocrinology and Metabolism (SBEM) and the Brazilian Association of Bone Assessment and Metabolism (ABRASSO).

Several drugs are available for the treatment of osteoporosis in postmenopausal women. Over the last decades, most patients requiring pharmacological intervention were offered antiresorptive drugs as first-line therapy, while anabolic agents were considered a last resource for those with therapeutic failure. However, recent randomized trials in patients with severe osteoporosis have shown that anabolic agents reduce fractures to a greater extent than antiresorptive medications. Additionally, evidence indicates that increases in bone mineral density (BMD) are maximized when patients are treated

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… At 24 months, the risk of new vertebral fracture was reduced by 48% (p < 0.001) in patients treated with romosozumab followed by alendronate, when compared with alendronate alone. … Moreover, nonvertebral fractures were reduced by 19% (p < 0.04) and hip fractures were reduced by 38% (p < 0.02) in patients who received romosozumab followed by alendronate compared with alendronate alone ( 17 ). …

The 2024 UK clinical guideline for the prevention and treatment of osteoporosis.

UNLABELLED: The National Osteoporosis Guideline Group (NOGG) has updated the revised UK guideline for the assessment and management of osteoporosis and the prevention of fragility fractures in postmenopausal women, and men age 50 years and older. This guideline is relevant for all healthcare professionals involved in osteoporosis management. INTRODUCTION: The UK National Osteoporosis Guideline Group (NOGG) first produced a guideline on the prevention and treatment of osteoporosis in 2008, with updates in 2013, 2017 and 2021. This paper presents a minor update of the 2021 guideline, the scope

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… (Ib)* | Superior to Alendronate (Ib)* | Superior to Alendronate (Ib)* | No Teriparatide | Ia | Ia | Ia | Superior to Alendronate (Ia) Risedronate (Ia) Denosumab (Ia) | Superior to Alendronate (Ia) | NAE | Yes Abaloparatide | Ia | Ia | IIb | Superior to Raloxifene (Ia) | Superior to Teriparatide (Ia) … New vertebral, non-vertebral, clinical, and hip fractures were all significantly lower in women treated with romosozumab followed by alendronate than in those treated with alendronate alone (Evidence level Ib). …

Bisphosphonate Use in Acute Spinal Cord Injury: A Focused Systematic Review on Zoledronic Acid.

Spinal cord injury (SCI) causes significant bone loss as a long-term complication, increasing fracture risk and healthcare costs. Bisphosphonates are widely studied for mitigating bone loss since they can prevent fractures and preserve rehabilitation potential in acute SCI patients. Zoledronic acid, in particular, stands out due to its high potency, dosing convenience, and better patient adherence. This review aims to evaluate the efficacy of bisphosphonates, particularly zoledronic acid, in mitigating bone loss in acute SCI. A systematic review was conducted following the Preferred Reporting

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… /administration and dosage"[Mesh] OR "Alendronate/pharmacology"[Mesh] OR "Alendronate/supply and distribution"[Mesh] OR "Alendronate/therapeutic use"[Mesh] ) OR ( "Bone Density Conservation Agents/administration and dosage"[Mesh] OR "Bone Density Conservation Agents/pharmacology"[Mesh] OR "Bone Density … Nitrogen-containing bisphosphonates, such as alendronate and risedronate, are administered orally (alendronate 70 mg and risedronate 35 mg weekly or risedronate and ibandronic acid 150 mg each monthly). …

Molecular-Based Treatment Strategies for Osteoporosis: A Literature Review.

Osteoporosis is an unavoidable public health problem in an aging or aged society. Anti-resorptive agents (calcitonin, estrogen, and selective estrogen-receptor modulators, bisphosphonates, anti-receptor activator of nuclear factor κB ligand antibody along with calcium and vitamin D supplementations) and anabolic agents (parathyroid hormone and related peptide analogs, sclerostin inhibitors) have major roles in current treatment regimens and are used alone or in combination based on the pathological condition. Recent advancements in the molecular understanding of bone metabolism and in bioengin

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… Eighteen months of abaloparatide treatment followed by 6 months of alendronate treatment was reported as an extension of ACTIVE, which compared abaloparatide with placebo both followed by alendronate. … alendronate alone [ 65 ]. …

UK clinical guideline for the prevention and treatment of osteoporosis.

UNLABELLED: The National Osteoporosis Guideline Group (NOGG) has revised the UK guideline for the assessment and management of osteoporosis and the prevention of fragility fractures in postmenopausal women, and men age 50 years and older. Accredited by NICE, this guideline is relevant for all healthcare professionals involved in osteoporosis management. INTRODUCTION: The UK National Osteoporosis Guideline Group (NOGG) first produced a guideline on the prevention and treatment of osteoporosis in 2008, with updates in 2013 and 2017. This paper presents a major update of the guideline, the scope

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… Zoledronate and risedronate are contraindicated in severe renal impairment (GFR ≤ 35 ml/min for zoledronate and ≤ 30 ml/min for risedronate), whilst alendronate and ibandronate are cautioned against (GFR ≤ 35 ml/min for alendronate and ≤ 30 ml/min for ibandronate). … New vertebral, non-vertebral, clinical and hip fractures were all significantly lower in women treated with romosozumab followed by alendronate than in those treated with alendronate alone ( evidence level Ib ). …

European guidance for the diagnosis and management of osteoporosis in postmenopausal women.

UnlabelledGuidance is provided in a European setting on the assessment and treatment of postmenopausal women at risk of fractures due to osteoporosis.IntroductionThe International Osteoporosis Foundation and European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis published guidance for the diagnosis and management of osteoporosis in 2008. This manuscript updates these in a European setting.MethodsSystematic literature reviews.ResultsThe following areas are reviewed: the role of bone mineral density measurement for the diagnosis of osteoporosis and assessment of fr

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… Hip fracture Alendronate, 5–0 mg [ 173 ] Vertebral fractures with BMD ≤0.68 g/m 2 71 2,027 2.2 1.1 0.49 (0.23–0.99) Alendronate, 5–10 mg d [ 176 ] FN T-score ≤−2 b 68 4,432 0.8 0.7 0.79 (0.43–1.44) Alendronate, 5–10 mg d [ 176 ] FN T-score ≤−2.5 b (subgroup analysis) NA 1,631 1.6 0.7 0.44 (0.18–1.97) … Hip fracture Alendronate, 5–0 mg | [ 173 ] | Vertebral fractures with BMD ≤0.68 g/m 2 | 71 | 2,027 | 2.2 | 1.1 | 0.49 (0.23–0.99) Alendronate, 5–10 mg d | [ 176 ] | FN T-score ≤−2 b | 68 | 4,432 | 0.8 | 0.7 | 0.79 (0.43–1.44) Alendronate, 5–10 mg d | [ 176 ] | FN T-score ≤−2.5 b (subgroup analysis) | …

Bisphosphonate-loaded bone cement: Background, clinical indications and future perspectives.

Bisphosphonates represent an established treatment against bone resorption and osseous loss. Local application could help increase bone mineral density while minimizing their systemic use side-effects. Bone cement, used on a large scale in orthopedic surgery and a historically successful drug carrier, could represent an effective scaffold. The aim of this review was to investigate the alterations produced on the cement's structure and properties by this mixture, as well as its antiosteoporotic and antitumor effect. After a thorough research of articles, title screening and duplicate removal we

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… Based on this study, Lewis et al. proposed addition of powder alendronate (ALN). Fatigue tests and porosity measurements were proven satisfactory, making the authors to strongly support this BP form for impregnation in bone cement[ 23 ]. Matuszewski et al. mixed 40 g of cement with 60 mg PAM. … 30 Schnitzler V Fayon F Despas C Investigation of alendronate-doped apatitic cements as a potential technology for the prevention of osteoporotic hip fractures:Critical influence of the drug introduction mode on the in vitro cement properties Acta Biomater 2011 7 2 759 770 20854940 10.1016/j.actbio …

Comparison of the prophylactic use of ibandronate and its use in early-stage osteonecrosis in rats with steroid-induced osteonecrosis of the femoral head.

OBJECTIVES: The aim of this study was to investigate the effects of ibandronate before and after the onset of osteonecrosis in rats with steroid-induced osteonecrosis of the femoral head. MATERIALS AND METHODS: A total of 24 female Sprague-Dawley rats were used in this study. Three groups were formed with eight rats in each group. The first group was the prophylactic group that received ibandronate treatment before and after the onset of osteonecrosis (Group PT). The second group received ibandronate treatment three weeks after the development of osteonecrosis (Group TAO). The third group was

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… Subtrochanteric insufficiency fractures in patients on alendronate therapy: A caution. J Bone Joint Surg [Br] 2007;89:349–353. doi: 10.1302/0301-620X.89B3.18146. 35. Kwek EB, Goh SK, Koh JS, Png MA, Howe TS. … An emerging pattern of subtrochanteric stress fractures: A long-term complication of alendronate therapy. Injury. 2008;39:224–231. doi: 10.1016/j.injury.2007.08.036. …

Zoledronic acid infusion for prevention and treatment of osteoporosis.

Osteoporotic fractures are associated with significant morbidity, reduced quality of life, increased mortality, and high health care costs. Bisphosphonates are standard therapy for treatment of osteoporosis. However, patient compliance and persistence with oral weekly or monthly bisphosphonate therapy are suboptimal and may lead to reduced effectiveness. Zoledronic acid (ZOL) is an intravenous bisphosphonate that is given once yearly for the treatment of osteoporosis via a medically supervised 15-minute infusion. This ensures compliance for a full 12 months. In clinical trials, an annual infus

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… In a study in 225 postmenopausal women who had been on oral alendronate therapy for at least 1 year, a single infusion of ZOL 5 mg maintained lumbar spine BMD at 1 year and had a safety profile similar to that of weekly oral alendronate 70 mg. 49 Patients should have an adequate daily intake of calcium … An emerging pattern of subtrochanteric stress fractures: a long-term complication of alendronate therapy? Injury. 2008;39:224–231. doi: 10.1016/j.injury.2007.08.036. 46. Neviaser AS, Lane JM, Lenart BA, Edobor-Osula F, Lorich DG. Lowenergy femoral shaft fractures associated with alendronate use. …

Modeling osteoporosis to design and optimize pharmacological therapies comprising multiple drug types.

For the treatment of postmenopausal osteoporosis, several drug classes with different mechanisms of action are available. Since only a limited set of dosing regimens and drug combinations can be tested in clinical trials, it is currently unclear whether common medication strategies achieve optimal bone mineral density gains or are outperformed by alternative dosing schemes and combination therapies that have not been explored so far. Here, we develop a mathematical framework of drug interventions for postmenopausal osteoporosis that unifies fundamental mechanisms of bone remodeling and the mec

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… Medication(s) | | MAPE | WMAPE | Shown in Data ref. | BMD (%) | CTX (%) | P1NP (%) | BSAP (%) | BMD (%) | CTX (%) | P1NP (%) | BSAP (%) Calibration datasets Alendronate 5–10 mg Q1D | Black et al., 2006 | 0.9 | 7.0 | 21.1 | — | 0.6 | 4.7 | 13.5 | — | Appendix 3—figure 1 Alendronate 70 mg Q1W | Saag et … | Efficacy: alendronate | 2.97 × 10 - 5 | 1 | Calibration | Equation 22 T alendronate | Effective half-life: alendronate | 1.53 × 10 2 | d | Calibration | Equation 22 η C bp | Max. contribution of bisphosphonates to osteoclast apoptosis rate | 1.00 | d - 1 | Calibration | Equation 26 Medication extension …

Diagnosis and management of osteoporosis in the older senior.

The older senior is at high risk for osteoporosis. It is important for healthcare providers to be fully aware of the potential risks and benefits of diagnosing and treating osteoporosis in the older senior population. Data indicate that bone mineral density testing is under-utilized and drug therapy is often not initiated when indicated in this population. Bone mineral density testing with central dual energy x-ray absorptiometry is essential and cost-effective in this population. All older seniors should be educated on a bone-healthy lifestyle including age-appropriate weight-bearing exercise

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… In an analysis of data from the Fracture Intervention Trial with alendronate, the relative risk reductions for clinical fractures at the hip, spine and wrist with alendronate therapy were found to be constant across all age groups up to the age of 85 years. 109 The absolute risk reduction (ARR) between … alendronate and placebo increased with increasing age. …

Clinical challenges in the management of osteoporosis.

While knowledge regarding the diagnosis and treatment of osteoporosis has expanded dramatically over the last few years, gaps in knowledge still exist with guidance lacking on the appropriate management of several common clinical scenarios. This article uses fictional clinical scenarios to help answer three challenging questions commonly encountered in clinical practice. The first clinical challenge is when to initiate drug therapy in a patient with low bone density. It is estimated that 34 million America have low bone density and are at a higher risk for low trauma fractures. Limitations of

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… Alendronate and risedronate have also been shown to reduce the risk for hip fractures ( Black et al 1996 ; McClung et al 2001 ). … The fracture intervention trial with alendronate did enroll some postmenopausal women with osteopenia. …

Clinical features of atypical femur fracture.

OBJECTIVES: We aim to elucidate the clinical outcomes of bisphosphonate-associated atypical femoral fracture and the clinical results depending on the bisphosphonate therapy period. METHODS: Twenty cases involving 15 patients who had been diagnosed with atypical femoral facture between 2004 and 2014 and who had been followed up for at least 12 months were retrospectively analyzed. The control group was composed of 15 typical femoral facture patients. We used plain radiography and physical examinations to determine the period of time required for fracture healing as well as complication occurr

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… As for bisphosphonate, alendronate was used in 10 cases and risedronate in 2 cases. Revision surgery involving a bone graft was performed due to nonunion in 1 out of 15 cases. … Subtrochanteric insufficiency fractures in patients on alendronate therapy: a caution J Bone Jt Surg Br 89 2007 349 353 10.1302/0301-620X.89B3.18146 17356148 7 Kwek E.B. Goh S.K. Koh J.S. Png M.A. Howe T.S. …

European guidance for the diagnosis and management of osteoporosis in postmenopausal women.

Guidance is provided in a European setting on the assessment and treatment of postmenopausal women at risk from fractures due to osteoporosis.IntroductionThe International Osteoporosis Foundation and European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis published guidance for the diagnosis and management of osteoporosis in 2013. This manuscript updates these in a European setting.MethodsSystematic reviews were updated.ResultsThe following areas are reviewed: the role of bone mineral density measurement for the diagnosis of osteoporosis and assessment of fracture

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… Alendronate 70 mg once weekly and risedronate 35 mg once weekly are the most commonly used bisphosphonates worldwide. … Hip fracture Alendronate 5–10 mg | Black 1996 [ 207 ] | Vertebral fractures with BMD ≤ 0.68 g/m 2 | 71 | 2027 | 2.2 | 1.1 | 0.49 | 0.23–0.99 Alendronate 5–10 mg c | Cummings 1998 [ 210 ] | FN T-score ≤ − 2 d | 68 | 4432 | 0.8 | 0.7 | 0.79 | 0.43–1.44 Alendronate 5–10 mg c | Cummings 1998 [ 210 ] | FN …

Weekly teriparatide injections successfully treated advanced bisphosphonate-related osteonecrosis of the jaws.

This study investigated whether weekly teriparatide (TPTD) injections are as effective as daily teriparatide injections for the treatment of stage 3 bisphosphonate-related osteonecrosis of the jaws (BRONJ) and compared serum markers of bone turnover between the two treatment regimens. Daily TPTD treatment has recently been reported to be effective for BRONJ, but there are no reports describing the effectiveness of weekly TPTD injections. We report two patients with stage 3 BRONJ. One patient was successfully treated with weekly TPTD injections and the other with daily TPTD injections. Changes

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… Case reports Case 1 An 87-year-old Japanese woman with a 4-year history of alendronate therapy (35 mg/week orally) was referred for the treatment of multiple fistulas with purulent discharge over the left maxillary ridge. … An 87-year-old Japanese woman with a 4-year history of alendronate therapy. a At presentation, there were multiple fistulas with purulent discharge over the left maxillary ridge ( arrowheads ). …

Utility of monthly minodronate for osteoporosis after gastrectomy: Prospective multicenter randomized controlled trials.

AimOsteoporosis in patients after gastrectomy is increasing with the aging of gastric cancer patients. Bisphosphonates are effective treatments for osteoporosis; however, their safety or efficacy in postgastrectomy patients has not been established. The purpose of this multicenter prospective intervention study was to investigate the impact of monthly minodronate on osteoporosis after gastrectomy.MethodsOf the 261 enrolled gastric cancer patients, 164 patients were diagnosed with osteoporosis based on criteria of the Japan Society of Osteoporosis. They were randomly assigned 1:1 to groups trea

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… Among them, bisphosphonates, such as alendronate 13 , 14 , 15 and minodronate, 16 , 17 exhibit strong efficacy for vertebral and hip fracture prevention and increasing bone mass. … Utility of alendronate in metabolic bone diseases after gastrectomy. Jpn J Gastroenterol Surg. 2011;44:361–73. 22. Kunisaki C, Tanaka Y, Kosaka T, Miyamoto H, Sato S, Suematsu H, et al. …

Current options for the treatment of Paget's disease of the bone.

Paget's disease of bone (PDB) is a chronic bone remodelling disorder characterized by increased osteoclast-mediated bone resorption, with subsequent compensatory increases in new bone formation, resulting in a disorganized mosaic of woven and lamellar bone at affected skeletal sites. This disease is most often asymptomatic but can be associated with bone pain or deformity, fractures, secondary arthritis, neurological complications, deafness, contributing to substantial morbidity and reduced quality of life. Neoplastic degeneration of pagetic bone is a relatively rare event, occurring with an i

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… Alendronate sodium is approved for the treatment of PDB at a dose of 40 mg/day for 6 months. … Ten years of alendronate treatment for osteoporosis in postmenopausal women. N Engl J Med. 2004;351:190–192. 102. Odvina CV, Zerwekh JE, Rao DS, Maalouf N, Gottschalk FA, Pak CY. Severely suppressed bone turnover: a potential complication of alendronate therapy. …

Endodontic therapy and Medication-related osteonecrosis of the jaw onset: a scoping review and expert opinion-based qualitative meta-synthesis.

INTRODUCTION: Medication-related osteonecrosis of the Jaw (MRONJ) is a serious side effect of bone-modifying agents (BMAs), including bisphosphonates, denosumab, and antiangiogenic drugs. Some dental procedures are recognized as local risk factors for MRONJ. Given the lack of specific guidelines for root canal therapy in patients treated with BMA, this scoping review aimed to investigate the risk of MRONJ associated with failed root canal therapy. Subsequently, a meta-synthesis of expert opinions was performed to identify existing recommendations and pitfalls of root canal therapy in patients

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… ] Turkey 2 62 64 F Breast cancer with BM #1: oral alendronate followed by iv zoledronate; #2: iv zoledronate #1: oral alendronate for 48 months and iv zoledronate for 1 month; 2#: 48 months #1: 3.5, 4.5, 47.; #2: 4.6 Yes 2 months 4 Zamparini F, 2021 [ 28 ] Italy Case – control Study (65 − 46) BP group … Regarding BMA therapy, the most common treatment was intravenous zoledronate (42/88, 47.7%), alone or in combination with oral alendronate, followed by alendronate (21/88, 23.9%), clodronate (11/88, 12.5%), ibandronate (6/88, 6.8%), neridronate (2/88, 2.3%), risedronate (1/88, 1.1%), denosumab (4/88, …

The Influence of Local Pamidronate Application on Alveolar Dimensional Preservation after Tooth Extraction-An Animal Experimental Study.

The aim of this randomized, controlled animal exploratory trial was to investigate the influence of local application of aminobisphosphonate pamidronate during the socket preservation procedure. Mandibular premolars were extracted in five Göttingen minipigs. Two animals underwent socket preservation using BEGO OSS (n = 8 sockets) and three animals using BEGO OSS + Pamifos (15 mg) (n = 12 sockets). After jaw impression, cast models (baseline, eight weeks postoperative) were digitized using an inLab X5 scanner (Dentsply Sirona) and the generated STL data were superimposed and analyzed with GOM I

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… The authors showed that statistically significantly lower loss in graft height was seen on the test side for Bio-Gide ® + alendronate (0.65 %) versus Bio-Gide ® (1.52 %), p = 0.002; Bio-Oss ® + alendronate (1.16 %) versus Bio-Oss ® (4.20 %), p = 0.001; and bone graft + alendronate (1.25 %) versus bone … However, five of the alendronate-treated transplanted bone grafts showed no osseointegration and necrosis of the overlying periosteum and were subsequently excluded from the evaluation. …