Effects of a 'Drug Holiday' on Bone Mineral Density and Bone Turnover Marker During Bisphosphonate Therapy.
10.11005/jbm.2013.20.1.31
- Author:
Sung Yeol KONG
1
;
Dae Young KIM
;
Eun Jin HAN
;
So Young PARK
;
Chang Hoon YIM
;
Sung Hoon KIM
;
Hyun Koo YOON
Author Information
1. Department of Internal Medicine, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea. hyunkooyoon@hotmail.com
- Publication Type:Original Article
- Keywords:
Bisphosphonate;
Bone mineral density;
Bone turnover marker;
Drug holiday
- MeSH:
Alkaline Phosphatase;
Bone Density;
Calcium;
Female;
Femur Neck;
Holidays;
Humans;
Phosphorus;
Retrospective Studies
- From:Journal of Bone Metabolism
2013;20(1):31-35
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Recently long-term safety of bisphosphonate raises issues about the duration of therapy. We examined the effects of a drug holiday (DH) on bone mineral density (BMD) and bone turnover markers. METHODS: In Korean, 125 women of 50 years of age or older with T-score< or =-3.0 of their lumbar or left femoral BMD initiated bisphosphonate from 1999 based on retrospective chart review. 125 patients who had used bisphosphonate> or =5 years started DH in 2006. Lumbar (L1-4), left femoral neck, total BMD, serum parameter (beta-crossLaps [CTx], phosphorus, total calcium, total alkaline phosphatase), and urinary parameter (calcium/creatinine ratio) were measured before, the time of starting, and after DH. RESULTS: After DH, lumbar, femoral neck and total BMD did not change significantly (0.757+/-0.093-->0.747+/-0.102, P=0.135, 0.567+/-0.079-->0.560+/-0.082, P=0.351, 0.698+/-0.008-->0.691+/-0.090 g/cm2, P=0.115, respectively). Serum CTx and total alkaline phosphatase were increased significantly (0.205+/-0.120-->0.791+/-0.44 ng/mL, P<0.001, 54.52+/-13.40-->60.42+/-15.543 IU/L, P=0.001, respectively). Urinary calcium/creatinine ratio increased significantly (0.132+/-0.076-->0.156+/-0.093, P=0.012). CONCLUSIONS: A DH could be cautiously considered in patients with long-term use of bisphosphonate if there is a concern about severe suppression of bone turnover with respect to long-term use because insignificant changes of BMD and significant increase of bone turnover markers are shown during the period.
