Effect of clodronate on calcium-phosphatemagnesium homeostasis, bone mass and vertebral deformities in postmenopausal women

Abstract

E~trogen deficiency due to menopause leads to progressive loss of bone mass, vertebral deformities and fractures. Clodronate is an inhibitor of bone resorption, developed as an agent to fight hypercalcemia and bone lysis. The aim of the study was tO evaluate the effect of the treatment with clodronate on Ca-P-Mg homeostasis, bone mass and vertebral deformities in postmenopausal women Twenty three postmonopausal outpatient women suffering from osteoporosis, with at least one vertebral crush fracture on standard Xray examination or bone mineral density (BMD) more than 2 SD below age matched normal values were included into the study The patients were treated with clodronate in a dose of 0,8 g daily, calcium carbonate 2 g daily and Is-vitamin D3 in a dose 0f0,25 p.g daily In each patient bioehemical parameters of Ca-P-Mg homeostasis, bone turnover markers and BMD with the method of dual energy X-ray absorptiometry (DXA) were determined and life standard questionaire was acquired It was found that clodronate was able to decrease bone pain within 7 days of the treatment. The treatment applied increased BMD by 4% in the lumbar spine (p<0,05) and by 5-10% in the three different regions of proximal femur (p<0,01). No changes in Ca-P-Mg homeostasis were observed.MONITORING ALENDRONATE-TREATED POSTMENO-PAUSAL WOMEN WITH AN IMMUNOASSAY FOR FREE (Dpd), a trifunctional pyridinium erosstlnk which provides structural rigidity to bone collagen, has been established as a sensitive and specific marker of bone resorption. Alendronate, a potent bisphosphonate; has been shown to significantly reduce bone resorption as assessed with total urinary Dpd measured by HPLC after acid hydrolysis. The free Dpd fraction, approximately 40% of the total excreted Dpd, can be measured using u simple and convenient EIA, Pyrilinks~-D. We have investigated the utility of the EIA for a~sessing alendronate-induced changes in bone resorption ~n.o.~teopenic and osteoporotic women. Baseline and one month post-treatment urines were collected from 24 postmenopausal women enrolled in a one-year open-label study of the effect of alendronate (10 rag/day) for preventing bone loss. We measured free Dpd, corrected for urinary creatinine (Dpd/Cr), on each sample. Mean baseline Dpd/Cr levels were elevated 58% above normal premenopausal levels (p=0.0001 ). After 1 month of therapy Dpd/Cr levels decreased an average of 27% (p=0.O01 ), however, subjects with elevated baseline levels responded with a greater reduction (39%, p=O.002). Measurement of free Dpd appears to provide rapid information on the efficacy of alendronate for reducing elevated bone resorption and may be suitable for monitoring therapeutic response and compliance in individual patients.The peptide hormone calcitonin has a muhidirectional physiological action The aim of the study was to evaluate the analgetic effect of synthetic human calcitonin Cibacalcin in patients (pts) with primary ostesporosis.Examinations were performed on 20 adult male and female pts suffering from acute back pain due to verteb...