Efficacy of bisphosphonates evaluated by biological bone markers

Abstract

© 2015, Medical Association of Thailand. All right reserved. This research aimed to study the benefits of bone markers on bisphosphonate, alendronate plus (vitamin D3 2800IU) administered once a week as a model especially regarding BetacrossLap, CTx. The enrolled cases were 306 (female = 282, male = 24) with high CTx (>0.300 ng/ml). The exclusion criteria were diabetes, abnormal renal or liver profiles, recent fractures and medication 1 month before the study. The duration of observation was 3 months for making decision on treatment. The blood for bone markers were checked at the first and third months. It was found that 10 percent of alendronate intake showed no response, i.e. neither decrease nor increase in CTx and 16.1 percent of cases showed strong bone suppression, i.e. high anti-resorption which the value of CTx below 0.100 ng/ ml after 3 months of the treatment. This bad condition may induce bone crack or stress fracture in the long run. It was also found 83.9 percent of cases presented good responses with the value of CTx at 0.100-0.299 ng/ml after 3 months. These cases can be continuing bisphosphonate until good satisfaction takes place. The benefits of bone markers help the physicians’ decision either to stop or continue the treatment. For the no response group, the bone markers (CTx) will save the cost of treatment. When the anti-resorption is marked (CTx <0.100 ng/ ml), the physicians can stop the treatment before unwanted effects occur. The bone markers shorten the time for producing the treatment results and indicting whether the bisphosphonates have been properly used. The bone markers, formative marker, PINP showed a decrease in bone formation after 3 months; PINP = 38.51%. This is a good lesson to be learned, that bone formation hardly ever occurs especially primary bone formation in cases where bisphosphonates is being taking. This study manifested the benefits of biological markers with quick response that can help the physicians treat the patients properly, save time and the cost of medication.