Minodronate for the therapy of osteoporosis.
Ther Clin Threat Manag. 2018;14:729-739
Authors: Ohishi T, Matsuyama Y
Minodronate is a third-generation bisphosphonate that was developed and permitted for scientific use in osteoporosis remedy in Japan. The mechanism of motion for suppressing bone resorption is the inhibition of farnesyl pyrophosphate synthase, a key enzyme within the mevalonic acid metabolic pathway of osteoclasts, to induce apoptosis of the cells. Minodronate is the strongest inhibitor of bone resorption among the many at the moment out there oral bisphosphonates. Massive randomized, placebo-controlled, double-blind scientific trials have revealed a rise in bone mineral density of each the lumbar backbone and femoral neck over three years of every day minodronate remedy and danger discount in vertebral fractures over 2 years of remedy. The rise in bone mass and the prevention of vertebral fractures are just like these with alendronate or risedronate. The incidence of adversarial occasions, particularly gastrointestinal disturbance, is identical as or lower than that with weekly or every day alendronate or risedronate. The distinctive mechanism of motion of minodronate through the inhibition of the P2X(2/three) receptor in contrast with different bisphosphonates could also be a bonus in decreasing low again ache in sufferers with osteoporosis. The month-to-month routine of minodronate, launched in 2011, is predicted to have higher affected person adherence and longer persistence. In experimental animal fashions, minodronate preserved, and even ameliorated, bone microarchitectures, together with microcracks and perforation of the trabeculae within the quick time period. The bottom incidence of bisphosphonate-related osteonecrosis of the jaw amongst all bisphosphonates and the dearth of atypical femoral fractures attributed to its use thus far, nonetheless, are partly as a result of solely a smaller inhabitants used minodronate than these utilizing different bisphosphonates. Up to now, minodronate is offered solely in Japan. Hip fracture danger discount has not been verified but. Extra scientific research on minodronate and its use in osteoporosis therapy, with a lot of topics, must be performed to confirm hip fracture danger discount and long-term outcomes.
PMID: 29713181 [PubMed]