Initiation of Monthly Minodronate Therapy at an Early Stage After Hip Fracture

Ohishi, Tsuyoshi; Fujita, Tomotada; Suzuki, Daisuke; Nishida, Tatsuya; Okabayashi, Ryo; Yamamoto, Kazufumi; Ushirozako, Hiroki; Banno, Tomohiro; Matsuyama, Yukihiro

doi:10.1016/j.jocd.2016.03.002

Cited by 1 publication

(3 citation statements)

References 31 publications

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“… 63 , 64 As with other bisphosphonates, patients with osteoporosis were more adherent to the monthly minodronate than to the daily or weekly regimens. 35 , 36 , 41 Longer persistence could be expected for monthly minodronate therapy than for daily or weekly therapy with other bisphosphonates.…”

Section: Discussionmentioning

confidence: 99%

“… 69 , 70 Monthly use of minodronate is also expected to help increase bone mass immediately after hip fracture without any adverse effect on the normal bone healing process and might prevent subsequent contralateral hip fracture. 41 …”

Section: Discussionmentioning

confidence: 99%

“…To date, only 1 paper examined the efficacy of minodronate on increasing BMD for patients with hip fractures. Ohishi et al 41 investigated BMD changes after hip fracture by administering monthly minodronate over 9 months in 51 patients with a mean age of 82.0 years. Minodronate was administered within 3 months after hip fracture surgery.…”

Section: Other Clinical Studies On Minodronatementioning

confidence: 99%

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Minodronate for the treatment of osteoporosis

Ohishi¹,

Matsuyama²

2018

TCRM

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Minodronate is a third-generation bisphosphonate that was developed and approved for clinical use in osteoporosis therapy in Japan. The mechanism of action for suppressing bone resorption is the inhibition of farnesyl pyrophosphate synthase, a key enzyme in the mevalonic acid metabolic pathway of osteoclasts, to induce apoptosis of the cells. Minodronate is the strongest inhibitor of bone resorption among the currently available oral bisphosphonates. Large randomized, placebo-controlled, double-blind clinical trials have revealed an increase in bone mineral density of both the lumbar spine and femoral neck over 3 years of daily minodronate therapy and risk reduction in vertebral fractures over 2 years of therapy. The increase in bone mass and the prevention of vertebral fractures are similar to those with alendronate or risedronate. The incidence of adverse events, especially gastrointestinal disturbance, is the same as or less than that with weekly or daily alendronate or risedronate. The unique mechanism of action of minodronate via the inhibition of the P2X(2/3) receptor compared with other bisphosphonates may be an advantage in reducing low back pain in patients with osteoporosis. The monthly regimen of minodronate, introduced in 2011, is expected to have better patient adherence and longer persistence. In experimental animal models, minodronate preserved, or even ameliorated, bone microarchitectures, including microcracks and perforation of the trabeculae in the short term. The lowest incidence of bisphosphonate-related osteonecrosis of the jaw among all bisphosphonates and the lack of atypical femoral fractures attributed to its use to date, however, are partly because only a smaller population used minodronate than those using other bisphosphonates. To date, minodronate is available only in Japan. Hip fracture risk reduction has not been verified yet. More clinical studies on minodronate and its use in osteoporosis treatment, with a large number of subjects, should be conducted to verify hip fracture risk reduction and long-term results.

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