Clinical Response to Oral Ibandronate in Paget’s Disease of Bone - Abstract
Introduction: The main goals of treatment of Paget’s disease of the bone (PDB) are to restorenormal bone metabolism, relieve bone pain and prevent future complications. Bisphosphonates have been used for several decades, as the class of choice for the treatment of PDB. Oral alendronate and risedronate are used in higher doses than those used for osteoporosis that is 30mg/day and 20 to 40mg/day for 2 and 6 months respectively. Pamidronate (60-180mg), ibandronate (2mg) and zolendronate (5mg) can also be used intravenously. There is no data on the treatment of PDB with oral ibandronate.
Objective: To evaluate the clinical and laboratory response of the treatment with oral ibandronate (150mg/month) for 6 months in 12 patients with PDB.
Methods: We evaluated the intensity of bone pain, the alkaline phosphatase (AP) and serum ß-cross-links-C telopeptide (sCTX) in 12 patients with PDB, mean age 68.6 ± 11,2 years-old, serum AP 1.49 ± 0,98 times the upper limit of normal (ULN). sCTX was elevated in 10 patients (mean 2,13 ± 1,2 times ULN), before treatment.
Results: After 6 months of treatment, the mean reduction in sCTX was 65,24 ± 28,9%, reaching 80% in 7 patients. The mean reduction of sAP was 49,21 ± 37,9%, with all patients having normal values in SAP after treatment. There was a significant clinical response in all patients, with marked improvement in bone pain.
Conclusion: Our data demonstrate high efficacy of oral ibandronate in the treatment of PDB at equivalent doses used in the treatment of osteoporosis.