Monthly ibandronate for the prevention of bone loss in patients after liver transplantation.
BACKGROUND
Osteopenia and osteoporosis are diseases frequently occurring after liver transplantation (OLT).


OBJECTIVE
In a prospective study, we have investigated the effect of ibandronate, vitamin D(3), and calcium on the prevention and treatment of posttransplant osteopenia and osteoporosis.


METHODS
The bone mineral density (BMD) of the lumbar spine (LS) and of the femoral neck (FN) were measured in 74 patients prospectively pre- and post-OLT.


RESULTS
Postoperatively the study group showed a consistent percentage increase in BMD (g/cm(2)) and a significantly increased BMD after 12 and 24 months in the LS (12 months: 1.05 ± 0.21 g/cm(2); P < .001 24 months: 1.11 ± 0.19 g/cm(2); P < .001) and the FN (12 months: 0.88 ± 0.16 g/cm(2); P < .002 24 months: 0.90 ± 0.15 g/cm(2); P < .001) in comparison with baseline pre-OLT (LS pre-OLT 0.98 ± 0.19 g/cm(2), FN 0.86 ± 0.14 g/cm(2)). The overall bone fracture rate was 5.4% up to 24 months.


CONCLUSIONS
Ibandronate once monthly per os significantly increased the BMD in the LS and FN after OLT at 12 and 24 months. The increased BMD limits the risk of fracture.
Department of General and Visceral Surgery, Zentralklinik, Bad Berka, Germany. Daniel.Kaemmerer@zentralklinik.de
D
D
Kaemmerer
B
B
Schmidt
G
G
Lehmann
G
G
Wolf
M
M
Hommann
U
U
Settmacher
D015502:Absorptiometry, Photon; D000284:Administration, Oral; D000469:Alkaline Phosphatase / Q000097:blood; D000596:Amino Acids / Q000652:urine; D015415:Biomarkers / Q000097:blood / Q000652:urine; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D001851:Bone Diseases, Metabolic / Q000000981:diagnostic imaging / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control*; D002118:Calcium / Q000008:administration & dosage; D016009:Chi-Square Distribution; D002762:Cholecalciferol / Q000008:administration & dosage; D003404:Creatinine / Q000652:urine; D019587:Dietary Supplements; D004164:Diphosphonates / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005272:Femur Neck / Q000000981:diagnostic imaging / Q000187:drug effects; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control*; D005858:Germany; D006801:Humans; D000077557:Ibandronic Acid; D016031:Liver Transplantation / Q000009:adverse effects*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000187:drug effects; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
D000596:Amino Acids; D015415:Biomarkers; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D002762:Cholecalciferol; C015484:pyridinoline; D003404:Creatinine; D000469:Alkaline Phosphatase; D002118:Calcium; D000077557:Ibandronic Acid