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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

Panagiotis Anagnostis
1   Haemophilia Centre of Northern Greece, 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
4   Department of Endocrinology, Hippokration Hospital, Thessaloniki, Greece
,
Timoleon-Achilleas Vyzantiadis
2   1st Department of Microbiology, Medical School, Aristotle University, Thessaloniki, Greece
,
Maria Charizopoulou
3   Department of Psychology, School of Philosophy, Aristotle University, Thessaloniki, Greece
,
Fotini Adamidou
4   Department of Endocrinology, Hippokration Hospital, Thessaloniki, Greece
,
Spyridon Karras
5   Department of Endocrinology and Metabolism, Agios Pavlos General Hospital, Thessaloniki, Greece
,
Dimitrios G. Goulis
6   Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, ‘‘Papageorgiou’’ General Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
,
Asterios Karagiannis
1   Haemophilia Centre of Northern Greece, 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
,
Vasilia Garipidou
1   Haemophilia Centre of Northern Greece, 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
,
Sofia Vakalopoulou
1   Haemophilia Centre of Northern Greece, 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
› Author Affiliations
Further Information

Publication History

Received: 14 January 2013

Accepted after major revision: 30 April 2013

Publication Date:
04 December 2017 (online)

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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
 

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