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Effects of switching weekly alendronate or risedronate to monthly minodronate in patients with rheumatoid arthritis: a 12-month prospective study

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Abstract

Summary

Switching weekly ALN or RIS to monthly MIN in patients with RA, of whom two-thirds were treated with low-dose PSL, significantly decreased bone turnover markers and increased BMD at 12 months, suggesting that monthly MIN may be an effective alternative treatment option of oral bisphosphonate treatment.

Introduction

The aim of this prospective, observational study was to evaluate the effects of switching weekly alendronate (ALN 35 mg) or risedronate (RIS 17.5 mg) to monthly minodronate (MIN 50 mg) in patients with rheumatoid arthritis (RA).

Methods

Patient characteristics were as follows: n = 172; 155 postmenopausal women, age 65.5 (44–87) years; T-score of lumbar spine (LS), −1.4; total hip (TH), −1.8; femoral neck (FN), −2.1; dose and rate of oral prednisolone (2.3 mg/day), 69.1 %; prior duration of ALN or RIS, 46.6 months; were allocated, based on their preference, to either the (1) continue group (n = 88), (2) switch-from-ALN group (n = 44), or (3) switch-from-RIS group (n = 40).

Results

After 12 months, increase in BMD was significantly greater in group 3 compared to group 1: LS (4.1 vs 1.2 %; P < 0.001), TH (1.9 vs −0.7 %; P < 0.01), and FN (2.7 vs −0.5 %; P < 0.05); and in group 2 compared to group 1: LS (3.2 vs 1.2 %; P < 0.05) and TH (1.5 vs −0.7 %; P < 0.01). The decrease in bone turnover markers was significantly greater in group 3 compared to group 1: TRACP-5b (−37.3 vs 2.5 %; P < 0.001), PINP (−24.7 vs −6.2 %; P < 0.05), and ucOC (−39.2 vs 13.0 %; P < 0.05); and in group 2 compared to group 1: TRACP-5b (−12.5 vs 2.5 %; P < 0.05) at 12 months.

Conclusions

Switching weekly ALN or RIS to monthly MIN in patients with RA may be an effective alternative treatment option of oral bisphosphonate treatment.

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Acknowledgments

The authors thank Dr. Kenrin Shi for his excellent cooperation in conducting the study.

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Correspondence to K. Ebina.

Ethics declarations

This observational study was conducted in accordance with the ethical standards of the Declaration of Helsinki and was approved by ethical review boards at the clinical center (approval number 11273-2; Osaka University, Graduate School of Medicine). Written informed consent was obtained from individual patients included in the study.

Conflicts of interest

This research was funded by Astellas Pharma, Inc. The funder had no role in the study design, data collection, data analysis, decision to publish, or preparation of the manuscript. Kosuke Ebina, Takaaki Noguchi, Makoto Hirao, Jun Hashimoto, Shoichi Kaneshiro, Masao Yukioka, and Hideki Yoshikawa declare that they have no conflict of interest.

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Ebina, K., Noguchi, T., Hirao, M. et al. Effects of switching weekly alendronate or risedronate to monthly minodronate in patients with rheumatoid arthritis: a 12-month prospective study. Osteoporos Int 27, 351–359 (2016). https://doi.org/10.1007/s00198-015-3369-6

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  • DOI: https://doi.org/10.1007/s00198-015-3369-6

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