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Monthly minodronate doses have similar efficacy to daily doses for bone mineral density
Okazaki R. Osteoporos Int. 2011. doi: 10.1007/s00198-011-1782-z
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Monthly administration of minodronate at doses of 30 mg or 50 mg has been found by Japanese researchers to have similar impact on bone mineral density and bone turnover markers to a daily 1 mg dose, according to this study.
The research team randomized 692 patients with involutional osteoporosis, splitting them into three groups: one that received a daily 1 mg dose of minodronate, one that received a monthly 50 mg dose and one that received a monthly 30 mg dose. Percent change in lumbar spine bone mineral density (BMD) at the 12-month mark was noted as the primary endpoint of the study. The authors also evaluated total hip BMD, bone turnover markets, serum calcium and parathyroid hormone levels.
According to the study results, the monthly 30 mg or 50 mg doses of minodronate were found noninferior to the daily 1 mg dose when lumbar spine BMD was compared among the three groups. The authors also noted comparable changes in total hip BMD and bone turnover markers.
“Monthly minodronate at 30 [mg] or 50 mg had similar efficacy as 1 mg daily in terms of change in [BMD] and bone turnover markers with similar safety profiles,” the authors wrote. “This new regimen provides patients with a new option for taking minodronate.”
This study of minodronate shows that monthly dosing of this drug is as efficacious in increasing bone density as daily 1 mg doses. The drug has previously shown activity in reducing vertebral fractures. It is approved for treatment of osteoporosis in Japan but not in the United States.
The drug is a potent bisphosphonate in many ways similar to the bisphosphonates already approved for US use by the FDA. The advantages of the drug would be another medication in the osteoporosis armamentarium giving physicians more choice in osteoporosis treatment. The drug, however, has not been shown to reduce hip fractures. Whether this is due to the studies not having enough numbers to access hip fractures or to a true lack of hip fracture efficacy is unknown. This may be an important point, however, for orthopedic surgeons.
— John D. Kaufman, MD
Valencia Orthopedics
Valencia, California