Abstract
BackgroundTartrate-resistant acid phosphatase-5b (TRACP-5b) and bone-specific alkaline phosphatase (BALP) levels have not been evaluated following ibandronate treatment in hemodialysis (HD) patients.MethodsTo evaluate the efficacy and tolerability of ibandronate, including TRACP-5b and BALP levels, in patients on HD, we conducted a 6-month retrospective study of 13 HD patients who were administered ibandronate at Kaetsu Hospital in Japan. All enrolled patients were placed on a regimen of intravenous ibandronate at a dose of 1 mg once every 4 weeks, from August 2015 to October 2016. Baseline and end-of-study levels of TRACP-5b and BALP were determined 1 month before and 6 months after the start of ibandronate treatment.ResultsTRACP-5b levels were significantly decreased from 785.3 ± 385.8 mU/dL at baseline to 638.2 ± 423.4 mU/dL at end of study (P = 0.03). Additionally, the changing levels of TRACP-5b were positively associated with baseline hip bone mineral density (BMD) (P = 0.02, r = 0.65). In contrast, BALP levels were not significantly changed. Moreover, hip BMD tended to decrease from 0.51 ± 0.10 g/cm2 at baseline to 0.47 ± 0.11 g/cm2 at end of study (P = 0.07). The tolerability index showed no statistical difference between baseline and end of study.ConclusionOur results indicate that ibandronate treatment in HD patients—especially those with low BMD—might sufficiently reduce TRACP-5b levels with no long-term changes in other clinical laboratory parameters. Therefore, ibandronate might be a feasible treatment option for HD patients who develop low BMD.
Highlights
Tartrate-resistant acid phosphatase-5b (TRACP-5b) and bone-specific alkaline phosphatase (BALP) levels have not been evaluated following ibandronate treatment in hemodialysis (HD) patients
Fourteen HD patients were started on ibandronate treatment between August 2015 and October 2016
We have shown that ibandronate treatment decreases TRACP-5b levels in HD patients, and that HD patients who had lower hip bone mineral density (BMD) might demonstrate improved TRACP-5b levels
Summary
Tartrate-resistant acid phosphatase-5b (TRACP-5b) and bone-specific alkaline phosphatase (BALP) levels have not been evaluated following ibandronate treatment in hemodialysis (HD) patients. Hemodialysis (HD) patients have a fourfold higher incidence of hip fracture compared with the general population [1]. Hip fractures are associated with low bone mineral density (BMD) [2] and increasing risk of mortality [3]. Proper treatment is important in HD patients with low BMD. Bisphosphonates are valuable agents for the treatment of low BMD [4] and provide vertebral and non-vertebral antifracture efficacy [5]. Ibandronate is a bisphosphonate that is available for intravenous use. A study in HD patients showed that about 36% of intravenously administered
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