The effect of monthly ibandronate on bone mineral density and bone turnover markers in patients with haemophilia A and B and increased risk for fracture

Panagiotis Anagnostis; Timoleon-Achilleas Vyzantiadis; Maria Charizopoulou; Fotini Adamidou; Spyridon Karras; Dimitrios G. Goulis; Asterios Karagiannis; Vasilia Garipidou; Sofia Vakalopoulou

doi:10.1160/TH13-01-0030

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2013; 110(02): 257-263
DOI: 10.1160/TH13-01-0030

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

The effect of monthly ibandronate on bone mineral density and bone turnover markers in patients with haemophilia A and B and increased risk for fracture

Authors

Panagiotis Anagnostis

¹Haemophilia Centre of Northern Greece, 2^nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece

⁴Department of Endocrinology, Hippokration Hospital, Thessaloniki, Greece
Timoleon-Achilleas Vyzantiadis

²1^st Department of Microbiology, Medical School, Aristotle University, Thessaloniki, Greece
Maria Charizopoulou

³Department of Psychology, School of Philosophy, Aristotle University, Thessaloniki, Greece
Fotini Adamidou

⁴Department of Endocrinology, Hippokration Hospital, Thessaloniki, Greece
Spyridon Karras

⁵Department of Endocrinology and Metabolism, Agios Pavlos General Hospital, Thessaloniki, Greece
Dimitrios G. Goulis

⁶Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, ‘‘Papageorgiou’’ General Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
Asterios Karagiannis

¹Haemophilia Centre of Northern Greece, 2^nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
Vasilia Garipidou

¹Haemophilia Centre of Northern Greece, 2^nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
Sofia Vakalopoulou

¹Haemophilia Centre of Northern Greece, 2^nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece

Abstract

Summary

Haemophilia A and B have been associated with increased prevalence of low bone mineral density (BMD). However, no study has so far evaluated the effects of anti-osteoporotic therapy on BMD in haemophilia. The primary endpoint of this prospective study was to estimate the effect of 12-month therapy of oral ibandronate 150 mg/ month on BMD in patients with haemophilia A and B. Secondary endpoint was its effect on turnover markers (BTM) of bone resorption [serum C-terminal telopeptide of type 1 collagen (sCTX), tartrate-resistant acid phosphatase band 5b] and bone formation (osteocalcin and bone-specific alkaline phosphatase. Ten adult patients with T-score < −2.5 SD or Z-score < −2 and/or increased risk of fracture according to FRAX model were included. All received 1,000 mg/day calcium carbonate with 800 IU/d cholecalciferol. Males with haemophilia A (n=7) or B (n=3) (mean age 43.5 ± 13.5 years) were studied. Ibandronate resulted in an increase in lumbar BMD (from 0.886 ± 0.169 to 0.927 ± 0.176 g/cm2, 4.7%, p=0.004). No change in BMD of total hip (from 0.717 ± 0.128 to 0.729 ± 0.153 g/cm2, p=0.963) or femoral neck (0.741 ± 0.135 to 0.761 ± 0.146 g/cm2, p=0.952) was noticed. Ibandronate led to a decrease in sCTX (from 0.520 ± 0.243 to 0.347 ± 0.230 ng/ml, −29.9%, p=0.042). No change was observed in other BTM. Ibandronate was generally well-tolerated. In conclusion, ibandronate significantly improved BMD in lumbar spine and reduced bone resorption in adults with haemophilia at increased risk of fracture. Its effect on hip BMD and bone formation markers was not significant.

Keywords

Haemophilia - osteoporosis - osteopenia - bone mineral density - ibandronate

Full Text

References

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