Elimination and Biochemical Responses to Intravenous Alendronate in Postmenopausal Osteoporosis
- 1 October 1997
- journal article
- clinical trial
- Published by Oxford University Press (OUP) in Journal of Bone and Mineral Research
- Vol. 12 (10), 1700-1707
- https://doi.org/10.1359/jbmr.1997.12.10.1700
Abstract
Postmenopausal women with established vertebral osteoporosis were studied for 2 years to determine the terminal elimination half-life and the duration of response to treatment with intravenous alendronate (30 mg) given over 4 days. The urinary excretion of alendronate followed a multiexponential decline. Approximately 50% of the total dose was excreted over the first 5 days, and a further 17% was excreted in the succeeding 6 months. Thereafter, there was a much slower elimination phase with an estimated mean terminal half-life of greater than 10 years (n = 11). Urinary excretion of hydroxyproline and calcium decreased significantly from pretreatment values by day 3, reaching a nadir by 1 week (40% and 67% decrease, respectively). Thereafter, hydroxyproline remained suppressed for the following 2 years. In contrast, urinary calcium excretion returned gradually toward pretreatment values over the first year and during the second year was comparable to pretreatment values. Serum activity of alkaline phosphatase activity decreased over 3 months (23% reduction), increased gradually thereafter, and returned to pretreatment values at month 24. Bone mineral density measured at the spine increased by approximately 5% during the first year and remained significantly higher than pretreatment values at 2 years. We conclude that a short course of high doses of intravenous alendronate is associated with a prolonged skeletal retention of the agent. This open study also suggests that this regimen has a sustained effect on bone turnover persisting for at least 1 year.Keywords
This publication has 25 references indexed in Scilit:
- The assessment of vertebral deformity: A method for use in population studies and clinical trialsOsteoporosis International, 1993
- Improved determination of the bisphosphonate alendronate in human plasma and urine by automated precolumn derivatization and high-performance liquid chromatography with fluorescence and electrochemical detectionJournal of Chromatography B: Biomedical Sciences and Applications, 1992
- Effects of amino-butylidene diphosphonate in hypercalcemia due to malignancyBone, 1991
- Bisphosphonate action. Alendronate localization in rat bone and effects on osteoclast ultrastructure.JCI Insight, 1991
- Bisphosphonates: A New Class of Drugs in Diseases of Bone and Calcium MetabolismPublished by Springer Science and Business Media LLC ,1989
- An evaluation of serum osteocalcin in pacet's disease of bone and its response to diphosphonate treatmentArthritis & Rheumatism, 1988
- A One Year Follow‐Up Study of the Distribution of 14C‐Clodronate in Mice and RatsBasic & Clinical Pharmacology & Toxicology, 1988
- Measuring serum calcium.BMJ, 1985
- EFFECT OF DICHLOROMETHYLENE DIPHOSPHONATE IN PAGET'S DISEASE OF BONE AND IN HYPERCALCÆMIA DUE TO PRIMARY HYPERPARATHYROIDISM OR MALIGNANT DISEASEThe Lancet, 1980
- MEASUREMENT OF 1,25‐DIHYDROXYCHOLECALCIFEROL IN MAN BY RADIOIMMUNOASSAYClinical Endocrinology, 1979