title: Intravenous ibandronate injections in postmenopausal women with osteoporosis: one-year results from the dosing intravenous administration study.
abstract: OBJECTIVE
  Although oral bisphosphonates are effective treatments for postmenopausal women with osteoporosis, oral dosing may be unsuitable for some patients. An efficacious intravenously administered bisphosphonate could be beneficial for such patients. Ibandronate, a potent nitrogen-containing bisphosphonate, can be administered using extended dosing intervals, either orally or by rapid intravenous injection. The aim of this study was to identify the optimal intravenous dosing regimen for ibandronate in postmenopausal women with osteoporosis.
  
  
  METHODS
  In a randomized, double-blind, double-dummy, phase III, noninferiority study, we compared 2 regimens of intermittent intravenous injections of ibandronate (2 mg every 2 months and 3 mg every 3 months) with a regimen of 2.5 mg of oral ibandronate daily, the latter of which has proven antifracture efficacy. The study group comprised 1,395 women (ages 55-80 years) who were at least 5 years postmenopausal. All patients had osteoporosis (lumbar spine [L2-L4] bone mineral density [BMD] T score less than -2.5). Participants also received daily calcium (500 mg) and vitamin D (400 IU). The primary end point was change from baseline in lumbar spine BMD at 1 year. Changes in hip BMD and in the level of serum C-telopeptide of type I collagen (CTX) were also measured, as were safety and tolerability.
  
  
  RESULTS
  At 1 year, mean lumbar spine BMD increases were as follows: 5.1% among 353 patients receiving 2 mg of ibandronate every 2 months, 4.8% among 365 patients receiving 3 mg of ibandronate every 3 months, and 3.8% among 377 patients receiving 2.5 mg of oral ibandronate daily. Both of the intravenous regimens not only were noninferior, but also were superior (P < 0.001) to the oral regimen. Hip BMD increases (at all sites) were also greater in the groups receiving medication intravenously than in the group receiving ibandronate orally. Robust decreases in the serum CTX level were observed in all arms of the study. Both of the intravenous regimens were well tolerated and did not compromise renal function.
  
  
  CONCLUSIONS
  As assessed by BMD, intravenous injections of ibandronate (2 mg every 2 months or 3 mg every 3 months) are at least as effective as the regimen of 2.5 mg orally daily, which has proven antifracture efficacy, and are well tolerated.
authors.affiliation: Université Claude Bernard Lyon 1 and INSERM Research Unit 403, Lyon, France. delmas@lyon.inserm.fr
authors.forename: Pierre D
authors.initials: PD
authors.lastname: Delmas
authors.forename: Silvano
authors.initials: S
authors.lastname: Adami
authors.forename: Cezary
authors.initials: C
authors.lastname: Strugala
authors.forename: Jacob A
authors.initials: JA
authors.lastname: Stakkestad
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Reginster
authors.forename: Dieter
authors.initials: D
authors.lastname: Felsenberg
authors.forename: Claus
authors.initials: C
authors.lastname: Christiansen
authors.forename: Roberto
authors.initials: R
authors.lastname: Civitelli
authors.forename: Marc K
authors.initials: MK
authors.lastname: Drezner
authors.forename: Robert R
authors.initials: RR
authors.lastname: Recker
authors.forename: Michael
authors.initials: M
authors.lastname: Bolognese
authors.forename: Claire
authors.initials: C
authors.lastname: Hughes
authors.forename: Daiva
authors.initials: D
authors.lastname: Masanauskaite
authors.forename: Penelope
authors.initials: P
authors.lastname: Ward
authors.forename: Philip
authors.initials: P
authors.lastname: Sambrook
authors.forename: David M
authors.initials: DM
authors.lastname: Reid
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D002118:Calcium / Q000008:administration & dosage; D024042:Collagen Type I / Q000097:blood; D004164:Diphosphonates / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D000077557:Ibandronic Acid; D007275:Injections, Intravenous; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy*; D010455:Peptides / Q000097:blood; D014807:Vitamin D / Q000008:administration & dosage
chemical_list: D050071:Bone Density Conservation Agents; D024042:Collagen Type I; D004164:Diphosphonates; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D014807:Vitamin D; D002118:Calcium; D000077557:Ibandronic Acid