Ibandronate is a potent nitrogen-containing bisphosphonate. It has a strong affinity for bone mineral and potently inhibits osteoclast-mediated bone resorption. Ibandronate is effective for the treatment of hypercalcemia of malignancy, metastatic bone disease, postmenopausal osteoporosis, corticosteroid-induced osteoporosis, and Paget's disease. Oral ibandronate is rapidly absorbed (t(max) < 1 hour), with a low bioavailability (0.63%) that is further reduced (by up to 90%) in the presence of food. Ibandronate has a wide therapeutic index and is not metabolized and, therefore, has a low potential for drug interactions. Given its metabolic stability, ibandronate is eliminated from the blood by partitioning into bone (40%-50%) and through renal clearance (CL(R) approximately 60 mL/min). The CL(R) of ibandronate is linearly related to creatinine clearance. The sequestration of ibandronate in bone (V(D) > 90 L) results in a multiphasic elimination (t((1/2)) range approximately 10-60 hours), characterized by the slow release of ibandronate from the bone compartment. The potency of ibandronate and its sequestration into bone allow ibandronate to be developed as oral and intravenous injection formulations that can be administered with convenient extended between-dose intervals.

Young children cleared the active metabolite oseltamivir carboxylate at a faster rate than older children and adults. Convenient administration recommendations for the oseltamivir oral suspension in children are possible to maintain drug exposure within the target window.

Patients or Other Participants: Subjects were postmenopausal women (age, 55-80 yr; 3 yr post menopause; n 144). Intervention(s): Once-monthly oral ibandronate 50, 100, or 150 mg or placebo was used. After the first cycle, the 50-mg arm was split, with participants continuing on either 50 or 100 mg. Main Outcome Measure(s): Primary outcome measures were safety, serum and urinary C-telopeptide (CTX), and serum ibandr-onate AUC 0-. Results: Once-monthly oral ibandronate was well tolerated, with a similar overall and upper gastrointestinal safety profile to placebo. Once-monthly ibandronate was also highly effective in decreasing bone turnover; substantial reductions from baseline in serum CTX (56.7% and 40.7% in the 150-and 100-mg arms, respectively; P 0.001 vs. placebo) and urinary CTX (54.1% and 34.6%, respectively ; P 0.001 vs. placebo) were observed at d 91 (30 d after the final dose). Analysis of the area under the effect curve (d 1-91) for change from baseline (percent days) in serum CTX and urinary CTX indicated a dose-response relationship. The AUC 0-for ibandronate increased with dose but not in a dose-proportional manner. Conclusions: These findings indicate a potential role for once-monthly oral ibandronate in the treatment of postmenopausal osteoporosis. (J Clin Endocrinol Metab 90: 5018-5024, 2005) O STEOPOROSIS IS A chronic, yet often silent, systemic skeletal disease, characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to increased bone fragility and susceptibility to fracture. It is a serious condition that, as a result of its most debilitating symptom, the fragility fracture, has an immense impact on society (1). Conservative estimates suggest that more than one third of adult women will sustain one or more osteo-porosis-related fractures in their lifetime (1, 2), resulting in substantial disability (3-5), mortality (6-9), and health care expenditure (3, 10, 11). Although effective therapies are available for its management , osteoporosis, like other chronic, largely asymptomatic diseases, is associated with poor therapeutic adherence. Indeed , recent studies indicate that both compliance and persistence with current osteoporosis medications are subopti-mal (12-18). A negative impact on therapeutic outcomes has also been observed, with nonadherent patients showing smaller increases in bone mineral density (BMD) (16, 17), smaller decreases in bone turnover (17, 19), and reduced antifracture efficacy (15, 18) compared with adherent counterparts. Adherence to therapy can be enhanced by decreasing the frequency and complexity of dosing (20). In osteoporosis management, patient preference for less complex dosing is illustrated by the recent introduction and rapid uptake of weekly oral bisphosphonate regimens (21-24). Prescription claims database studies [IHCIS (Integrated Healthcare Information Services, Inc.) (12); NDCHealth (13)] highlight the positive impact of less frequent bisphosphonate dosing on therapeutic adherence, with improved 1-yr persistence rates ob...

Exposures (AUC(inf)) to both the parent drug and active metabolite were increased by more than 80% in the small number of very elderly subjects presented here. However, oseltamivir was well tolerated by these subjects.

Purpose Self-regulation in eating is significant for enhancing life expectancy of people with cystic fibrosis (CF), but research with this population is scarce. Methods In a cross-sectional study, adults with CF completed a number of psychometric scales exploring typical eating behaviours that may increase calorific intake including motivations to eat palatable foods and scales that may be associated with decreased calorific intake: mindfulness, mindful eating and self-compassion. Results Findings suggested that motivations to eat palatable foods and eating behaviours correlate with higher BMI, while mindfulness, mindful eating and self-compassion did not reach significance. Mindfulness and mindful eating moderated the relationship between emotional eating and BMI, while self-compassion did not moderate this relationship. Conclusions There is a need to develop healthy and effective means of enhancing calorific intake, where this is indicated, adapting mindful eating principles to focus on increasing both self-regulation and pleasure in eating while reducing emotional eating may be one means of doing this. Level of evidence Level V, cross-sectional descriptive study.