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Long-Term Effects of Neridronate and its Discontinuation in Patients with Primary Hyperparathyroidism
- Source :
- Calcified Tissue International. 89:21-28
- Publication Year :
- 2011
- Publisher :
- Springer Science and Business Media LLC, 2011.
-
Abstract
- In patients with primary hyperparathyroidism (PHPT) not suitable for surgical correction, a skeletal protection with bisphosphonates is considered a reasonable option, but the long-term effects after treatment discontinuation are not well known. Sixty postmenopausal women with PHPT were given 400-600 IU vitamin D(3) daily and 100 mg neridronate IV every 2 months for 2 years with 2 additional years of follow-up without antiresorptive therapies. Bone mineral density (BMD) progressively rose by 6.7 ± 7.6% (SD) and by 2.9 ± 4.5% at the spine and femoral neck, respectively. During follow-up, mean BMD progressively fell, but after 2 years it was still 3.9 ± 5.5% higher than baseline values at the spine. Bone alkaline phosphatase and serum C-telopeptide of type I collagen decreased significantly within 6 months (28 and 49% versus baseline, respectively) and rose to baseline values within 6-12 months during follow-up. Serum PTH significantly rose from baseline during treatment, but it remained significantly higher than baseline during follow-up. The PTH changes were significantly correlated with serum 25-hydroxyvitamin D (25OHD) levels. In conclusion, in this study we observed that in patients with mild PHPT treatment with bisphosphonates is associated with the expected changes in bone-turnover markers and that the significant increases of both hip and spine BMD are partially maintained for at least 2 years after treatment discontinuation at the vertebral site. The marked increases in serum PTH levels, particularly in subjects with low 25OHD levels, persist after treatment discontinuation and this raises the suspicion that this might reflect a worsening of PHPT.
- Subjects :
- bisphosphonate
medicine.medical_specialty
Endocrinology, Diabetes and Metabolism
medicine.medical_treatment
Osteoporosis
Urology
Collagen Type I
Time
hyperparathyroidism
Endocrinology
medicine
Vitamin D and neurology
Humans
Orthopedics and Sports Medicine
neridronate
Osteoporosis, Postmenopausal
Aged
Cholecalciferol
Femoral neck
Bone mineral
Hyperparathyroidism
Bone Density Conservation Agents
Diphosphonates
Femur Neck
business.industry
Middle Aged
Bisphosphonate
Alkaline Phosphatase
Hyperparathyroidism, Primary
medicine.disease
Surgery
Discontinuation
medicine.anatomical_structure
Parathyroid Hormone
Female
Peptides
business
Primary hyperparathyroidism
Subjects
Details
- ISSN :
- 14320827 and 0171967X
- Volume :
- 89
- Database :
- OpenAIRE
- Journal :
- Calcified Tissue International
- Accession number :
- edsair.doi.dedup.....13063f3056b07403e1833dc2678e7846