Osteonecrosis of the jaw in a patient under treatment of osteoporosis with oral bisphosphonate

Although uncommon in patients under oral therapy, bisphosphonate-related osteonecrosis of the jaw (BRONJ) can be a very severe issue. Early intervention with surgical resection should be the preferable method of treating any stage of the disease, resulting in better outcomes and decreasing the morbidity of this condition. A 77-year-old female patient attended the Special Care Dentistry Centre of the University of São Paulo Faculty of Dentistry (CAPE FOUSP) complaining mainly of "an exposed bone that appeared after tooth extraction performed six months earlier". The patient was diagnosed with osteonecrosis associated with bisphosphonate (sodium ibandronate) and surgically treated with removal of bone sequestration and antibiotic therapy. The patient was followed up for six years (a total of 6 appointments), presenting good general health and no sign of bone exposure. Imaging findings showed no changes related to BRONJ either.

Metrology and visual analysis of English literature regarding osteoporosis in the past 5 years: Based on the web of science / 中国组织工程研究

BACKGROUND: Osteoporosis has always been a hotspot in medical research. Visual analysis of English literature regarding osteoporosis can intuitively understand the research status, hotspots and frontiers in this field, and help researchers to hold on the research topic and direction. OBJECTIVE: To perform bibliometric, co-presence, co-citation, and visual analyses of English literature regarding osteoporosis, and to explore the relevant research status, research hotspots and dynamic frontiers in this field in the past 5 years. METHODS: The CiteSpace software was used for co-presence analysis of the authors, institutions, countries, and keywords and for co-citation analysis of cited authors, references, and journals in the 2015-2019 related literature included in the Science Citation Index Expanded (SCI-E) of Web of Science (WOS). RESULTS AND CONCLUSION: A total of 2 980 articles were included. High-yielding countries include China, the United States, Japan, South Korea, and the United Kingdom. The main research institutions are Pittsburgh University, Harvard University, McMaster University, Oxford University, and other world-renowned universities. Shanghai Jiao Tong University wins a place in the orthopedics research. As high-yielding authors, Hong-Wen Deng focuses on genetic and osteoporosis mechanisms; Hiroyuki Kato, Yukio Nakamura, and Takako Suzuki jointly focus on the development of anti-osteoporosis drugs such as denosumab and ibandronate; Jonathan D Adachi focuses on vitamin D and osteoporosis and bone metabolism research; William D Leslie focuses on dual-energy bone mineral density assessment of osteoporosis; JA Kanis focuses on the appropriate population and timing for anti-osteoporosis. Osteoporosis International and Journal of Bone and Mineral Research published the most of research regarding osteoarthritis. New England Journal of Medicine, LanceT, JAMA-J and other top publications are also very concerned about osteoporosis research. The research discipline involves clinical and basic disciplines, with a focus on basic subjects. Advances in the development of anti-osteoporosis drugs are an important entry point for basic medical research. Lack of osteoporosis, zoledronic acid, glucocorticoid-induced osteoporosis, fat mass, oophorectomy, osteoporosis, mineral density, ovarian cancer, anti-osteoporosis, and bone metabolism is the frontier of osteoporosis research. In 2015-2016, animal research and senile osteoporosis were hotspots. In 2016-2017, the design of randomized trials, adult bone metabolism, and physical activity interventions were emerging areas of osteoporosis research. In 2017-2019, glucocorticoid-induced osteoporosis, mesenchymal stem cells and activation of cellular pathways were emerging areas of osteoporosis research. To conclude, CiteSpace can be used to bibliometrically analyze the English literature of osteoporosis and intuitively reveal the overall development trend of osteoporosis research in the past 5 years. Therefore, it can provide references for osteoporosis scholars in the reference content and development direction of the topic, and the results have certain significance.

The effectiveness of zoledronic acid and ibandronic acid as therapy for bone metastases in multiple myeloma: A systematic review

Zoledronic acid and ibandronic acid are used in preventing skeletal-related event (SRE) in multiple myeloma (MM).Both drugs were listed in the Indonesian formulary. There was no available head-to-head comparative study, hence theneed for a systematic review. The purpose of this systematic review was to describe the effectiveness of intravenouszoledronic and ibandronic acids in preventing SRE. The search for articles was conducted on accessible databases withthe potential to provide relevant research material such as PUBMED, EBSCOhost, and ScienceDirect. The articleswere limited to randomized controlled trials on both drugs in MM patients, published between 1980 and 2018. Theoutcomes were SRE, progression-free survival (PFS), overall survival (OS), and adverse event (AE). Thirteen articleswere selected. According to the results obtained, the effectiveness of zoledronic acid in preventing SRE was superiorto placebo or clodronic acid but not superior to denosumab and pamidronic acid. Ibandronic acid was not superior toplacebo or pamidronic acid. The effectiveness of both drugs in preventing SRE was directly proportional to PFS andOS. In conclusion, zoledronic acid was superior to ibandronic acid, but with more occurrence of AE. However, the AEcould be reduced by prolonging the duration of the drug use.

Pharmacokinetic Characteristics of Ibandronate and Tolerability of DP-R206 (150 mg Ibandronate/24,000 IU Vitamin D3) Compared to the Ibandronate (150 mg) Monotherapy in Healthy Adults

Ibandronate (a bisphosphonate) is commonly used as an treatment of osteoporosis in combination with vitamin D. Monthly DP-R206-a novel, fixed-dose combination tablet (150 mg ibandronate/24,000 IU vitamin D3)-was recently developed to enhance patient compliance. This open, randomized, two-period crossover study was conducted to compare the pharmacokinetics of ibandronate when administered as DP-R206 or 150 mg ibandronate to healthy adult volunteers. Each volunteer was randomly allocated to receive single-dose DP-R206 or ibandronate with a 28-day washout period between treatments. Blood samples were assessed using pharmacokinetic analysis. Plasma ibandronate concentrations were determined using liquid chromatography-tandem mass spectrometry. Safety and tolerability assessments were performed throughout the study. In total, 103 participants received the study drugs and 72 participants completed the study. The geometric mean ratios (DP-R206/ibandronate) of the maximum concentration (C(max)) and the area under the plasma concentration time curve from time zero to the last concentration (AUC(last)) values were 0.959 (90% CI: 0.820-1.120) and 0.924 (90% CI: 0.805-1.060), respectively. The frequencies of adverse events (AEs) and drug reactions were similar between treatment groups, and all AEs were recovered without sequalae. Ibandronate pharmacokinetics, tolerability, and safety are comparable when administered to healthy individuals, regardless if administered as DP-R206 or ibandronate.

Efficacy and Safety of Monthly 150 mg Oral Ibandronate in Women with Postmenopausal Osteoporosis: A Systematic Review and Meta-analysis of Randomized Controlled Trials

BACKGROUND/AIMS: The aim of this study was to assess the efficacy and safety of monthly oral 150 mg ibandronate in women with postmenopausal osteoporosis (PMO). METHODS: A systematic review and meta-analysis were performed to determine treatment efficacy and safety outcomes between monthly oral 150 mg ibandronate and weekly 70 mg alendronate, daily 2.5 mg ibandronate, and a placebo. RESULTS: Eight randomized controlled trials were included in this systematic review and meta-analysis. Once-monthly 150 mg ibandronate therapy was clinically comparable to weekly 70 mg alendronate, showing increased bone mineral density (BMD) in both the lumbar spine and total hip. Pooled data from two cross-over trials showed that significantly more women with PMO preferred once-monthly ibandronate therapy to once-weekly alendronate therapy (relative risk [RR], 2.422; 95% confidence interval [CI], 2.111 to 2.825; p < 1 x 10(-8)) and found the monthly ibandronate regimen more convenient than the weekly alendronate regimen (RR, 3.096; 95% CI, 2.622 to 3.622; p < 1 x 10(-8)). Monthly 150 mg ibandronate therapy resulted in a significantly higher change in BMD of the lumbar spine than with the placebo. A once monthly 150 mg regimen produced greater increases in lumbar spine, total hip, femoral neck, and trochanter BMD than daily treatment, with a similar incidence of adverse events between the groups. CONCLUSIONS: Once monthly 150 mg ibandronate therapy was clinically comparable to weekly 70 mg alendronate, and patients strongly preferred the convenience of monthly ibandronate over weekly alendronate. Monthly 150 mg ibandronate was superior to, and as well tolerated as, the daily treatment.