Long-term biochemical response after bisphosphonate therapy in Paget's disease of bone. Proposed intervals for monitoring treatment

Álvarez, Luisa; Peris, Pilar; Guañabens, Núria; Vidal, Sergio; Quintó, Llorenç; Monegal, Ana; Pons, F; Am, Ballesta; Múñoz-Gómez, J

doi:10.1093/rheumatology/keh185

Cited by 20 publications

(16 citation statements)

References 15 publications

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“…Monitoring intervals could be assessed from the post-treatment nadir and might need to be at 6-to 12-month intervals. (19) This study shows that this would be more than adequate in patients treated with ZOL. This approach would have considerable cost advantages, particularly in health care systems where there is an emphasis on moving long-term monitoring of chronic diseases from secondary to primary care.…”

Section: Discussionmentioning

confidence: 73%

Long-Term Control of Bone Turnover in Paget's Disease With Zoledronic Acid and Risedronate

Hosking

Lyles

Brown

et al. 2007

Journal of Bone and Mineral Research

144

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A single 5-mg infusion of zoledronic acid restores biochemical markers of bone turnover into the reference range in the majority of patients with Paget's disease and maintains biochemical remission for at least 2 years. This effect is largely independent of pretreatment disease activity and prior bisphosphonate therapy.Introduction: Zoledronic acid (ZOL) is a potent bisphosphonate that produces a rapid and complete control of the increased bone turnover of Paget's disease. Long-term control of disease activity is an important aim of treatment in the hope that this will reduce the risk of complications such as deformity, fracture, and degenerative joint disease. Materials and Methods:This study compares the ability of ZOL 5 mg given as a 15-minute intravenous infusion with risedronate (RIS) 30 mg daily by mouth for 60 days to maintain long-term control of bone turnover. No bisphosphonate was given during the extension study. All patients (n ‫ס‬ 296) who achieved a therapeutic response, defined as normalization or a >75% reduction in the total alkaline phosphatase (total ALP) excess above the midpoint of the reference range, were eligible for inclusion. Results: ZOL maintained the mean level of total ALP at the middle of the reference range, whereas those treated with risedronate showed a linear increase in total ALP from the 6-month post-treatment time-point. Both treatments resulted in a linear relationship between the 6-month nadir and 24-month total ALP. The relationship for RIS was shifted upward, showing that for a given level of post-treatment biochemical activity, bone turnover increased with time. This was in contrast to the ZOL-treated patients where total ALP generally remained unchanged over this 18-month extension period. A similar pattern of response was seen with the other bone turnover markers. Conclusions: ZOL maintains bone turnover within the reference range over 24 months from the initiation of treatment. A reduction in the incidence and severity of long-term complications may require persistent normalization of bone turnover over many years, and this now seems a realistic possibility with ZOL.

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Section: Discussionmentioning

confidence: 73%

Long-Term Control of Bone Turnover in Paget's Disease With Zoledronic Acid and Risedronate

Hosking

Lyles

Brown

et al. 2007

Journal of Bone and Mineral Research

144

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“…Bone formation markers (total ALP, BALP, P1NP,OHP) and resorption markers (urine NTX, serum CTX, urine CTX) are significantly higher in untreated Paget's patients than in healthy individuals. 95,96 In a comparative study on the biological variation of bone markers in Paget's disease, serum markers showed less variation than the urine markers. This study reported that serum BAP and P1NP were the most sensitive markers in monitoring disease progress in Paget's disease.…”

Section: Osteoporosismentioning

confidence: 99%

Biochemical markers of bone turnover – uses and limitations

2014

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Bone turnover markers of resorption and formation are released during the process of bone remodelling. These markers have been extensively studied in a number of therapeutic trials of osteoporosis during the past decade. This has led to better understanding of their physiology, clinical applications and possible ways to optimize analytical techniques. Bone markers can complement the results of bone mineral density in the management of osteoporosis, but their use in clinical practice is challenged by pre-analytical and analytical variability. This review will discuss different types of bone markers, their limitations, use in different metabolic bone diseases and current recommendations from the International Osteoporosis Foundation and the International Federation of Clinical Chemistry and Laboratory Medicine bone marker standards working group.

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“…Biochemical markers of bone turnover provide valuable information regarding the efficacy of antiresorptive therapy and are useful tools for assessing the effect of therapy in disorders 22,23 ; u-NTx and BAP values are generally utilized for the evaluation of bisphosphonate therapy 2,4,9,10,11,13,24 . The values of u-NTx and BAP may represent the present dynamic status of bone turnover, whereas BMD is integral for the diagnosis of osteoporosis.…”

Section: Discussionmentioning

confidence: 99%

Potential excessive suppression of bone turnover with long-term oral bisphosphonate therapy in postmenopausal osteoporotic patients

Iizuka

Matsukawa

2008

Climacteric

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Long-term biochemical response after bisphosphonate therapy in Paget's disease of bone. Proposed intervals for monitoring treatment

Cited by 20 publications

References 15 publications

Long-Term Control of Bone Turnover in Paget's Disease With Zoledronic Acid and Risedronate

Long-Term Control of Bone Turnover in Paget's Disease With Zoledronic Acid and Risedronate

Biochemical markers of bone turnover – uses and limitations

Potential excessive suppression of bone turnover with long-term oral bisphosphonate therapy in postmenopausal osteoporotic patients

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