PREVENTIVE AND THERAPEUTIC STRATEGIES FOR OSTEOPOROSIS (A HIGHLY EFFICACIOUS RISEDRONATE-35MG ONCE WEEKLY)
ABSTRACT: Based on WHO
Criteria-1997, osteoporosis (OST) can be diagnosed clinically when the BMD (by
DEXA) of the spine, hip or mid-radius is over-2.5 standard deviation (SD) below
that of the young adult. In clinical practice, the most frequent OSTS can be
categorized into 3 types, Type I-OST (PMO: Post Menopause OST), Type II-OST
(ARO: Age-Related OST), and Type III-OST (CIO: Corticosteroid-Induced OST).
Diabetic osteopenia and osteoporosis become major issues in daily clinical
experiences. Recent studies indicated that the probable causes of diabetic
osteopenia can be suggested: 1 AGE-modified collagen affected osteoblastic cell
differentiation and function; 2. could be responsible for
osteopenia-osteoporosis (esp. in post-menopause) in patients with diabetes
mellitus. One of the 3 Missions of International Osteoporosis Foundation is to
motivate people to take action to prevent, diagnose, and treat Ost. The Treatment
Update of OST can also be grouped into three interventions: 1 Healthy Life
Style as mentioned in the Prevention, 2 Calcium Supplement 1-1.5 g/day, 3A
Drugs (Estrogen, Bisphosphonates, Calcitonin, Growth Hormone, SERMs, Strontium
Ranelate (SR), Vitamin D, Fluoride, PTH-PTHRP, and 3B Symptomatic (Lumbar
Support etc). The 3rd Generation (Gen.) Bisphosphonates (BISPs) investigated in
humans, numbered in increasing order of potency are: Neridronate, Aledronate,
Olpadronate, Risedronate, Ibandronate, Zoledronate. Alendronate (ALE) and
Risedronate (RIS) are available in Indonesia. The novel BISP, Risedronate (RIS)
is 5-fold more potent than ALE. Most recent studies on PMO demonstrated that
RIS of 35 mg, or 50 mg Once a Week (OaW) provided the same efficacy and safety as
the daily 5 mg regimen; therefore, the lower dose, 35 mg OaW can be considered as
optimal dose for PMOs or other osteoporotic patients who desire OaW regimen. In
addition, RIS can be prescribed without dosage adjustment for patients with
mild or moderate renal impairment (creatinine clearance more than 20
ml/minute). Conclusions: OST, such as PMO, ARO, CIO, and diabetic osteopenia
are the most prevalent bone disorders affecting ageing adults in Indonesia.
Motivation of people to take action of prevention and treatment of OST should
be intensified and socialized. RIS, a novel 3rd Gen-BISP has been proven to be
effective and safe to prevent and to treat OST in a dosage of 5 mg OD, even
with the same efficacy and safety if such a drug to be given 35 mg once a week.
Importantly, it can be given safely without dosage adjustment as long as
creatinine clearance of patients is more than 20 ml/min.
Author: Askandar Tjokroprawiro
Journal Code: jpkedokterangg050022
