Efficacy and safety of alendronate in the prevention of bone loss in renal transplant recipients

Mowla, Karim; Shahbazian, H B; Peydayesh, B; Ehsanpour, Ali

doi:10.4103/0971-4065.37022

Cited by 5 publications

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“…Hence, both denosumab and alendronate demonstrated an excellent renal safety profile in the current study. There were no transplant rejections or more kidney function‐related AEs in either the denosumab or alendronate group, consistent with previous studies demonstrating a favorable level of renal safety reported in both the general population and those with renal transplantation 4,25–28 …”

Section: Discussionsupporting

confidence: 85%

“…There were no transplant rejections or more kidney function-related AEs in either the denosumab or alendronate group, consistent with previous studies demonstrating a favorable level of renal safety reported in both the general population and those with renal transplantation. 4,[25][26][27][28] In addition, bone mineral biomarkers did not show any significant change in the three groups except for a significant decrease in PTH and a significant increase in serum phosphate in the denosumab group. However, all values were in the normal range.…”

Section: Ta B L Ementioning

confidence: 83%

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Evaluation of the efficacy and tolerability of alendronate versus denosumab in kidney transplant patients with reduced bone mineral density

Sayed,

El Wakeel,

Elseasi

et al. 2023

Pharmacotherapy

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PurposeTo compare the effect of denosumab and alendronate on bone mineral density (BMD) in renal transplant recipients (RTRs) with low bone mass.MethodsPatients were randomized to receive either denosumab subcutaneously (60 mg/6 months), oral alendronate (70 mg/week), or no treatment for 1 year. The three groups were prescribed daily calcium and vitamin D. Primary outcome was BMD assessed at lumbar spine, hip, and radius and measured by dual‐energy X‐ray absorptiometry (DEXA) at baseline and after 6 and 12 months. Adverse events and laboratory assessments (calcium, phosphate, vitamin D, renal functions, and intact parathyroid hormone) were monitored for all patients. Quality of life was assessed at baseline and after 6 and 12 months for all patients.ResultsNinety RTRs were included in the study (30 in each group). Baseline clinical characteristics and BMD values were comparable in the three groups. After 12 months, lumbar spine T‐score of patients treated with denosumab and alendronate showed a median increase of 0.5 [95% confidence interval (CI): 0.4–0.6] and 0.5 (95% CI: 0.4–0.8), respectively, and patients in the control group showed a decrease of −0.2 (95% CI: −0.3 to −0.1), p < 0.001. Denosumab and alendronate showed a significant comparable gain in T‐scores at hip and radius versus a significant decrease in the control group. Adverse events and laboratory values were similar in the three groups. Both treatments resulted in comparable significant improvement in physical functioning, physical role limitations, vitality, and pain scores.ConclusionDenosumab and alendronate showed comparable efficacy in improving BMD at all measured skeletal sites and were safe and well‐tolerated, with no serious adverse effects reported in RTRs with low bone mass. The study was registered on ClinicalTrials.gov, number NCT04169698.

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Section: Discussionsupporting

confidence: 85%

Section: Ta B L Ementioning

confidence: 83%

Evaluation of the efficacy and tolerability of alendronate versus denosumab in kidney transplant patients with reduced bone mineral density

Sayed,

El Wakeel,

Elseasi

et al. 2023

Pharmacotherapy

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“…Both may persist months or even years after delivery (22,23). Despite this, deterioration in renal function is not expected even after a short period, but data suggest that these patients are more likely to develop chronic kidney disease in their later years (24)(25)(26). In a similar study, 54 pregnant women were prospectively followed up with postpartum 1 st day, 6 th week, 3 rd month, and 6 th month parameters and it was shown that hypertension persisted in 42.6% (23/54) and proteinuria in 48.1% (26/54) of the patients at 6th week (9).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Hypertension and Renal Function in Preeclamptic Women: A Follow-Up Study at 6th Week of Postpartum

Ayguler,

Anik Ilhan

2023

Gynecol Obstet Reprod Med

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OBJECTIVES: Chronic hypertension stands as the primary contributing factor for cardiovascular ailments among women who have experienced preeclampsia. The purpose of this research is to examine how often preeclamptic symptoms persist at the postpartum 6th week. STUDY DESIGN: The study included 50 singleton pregnant women in the third trimester who were diagnosed with preeclampsia according to ACOG criteria, were older than 18 years, had no known hypertension before the 20th gestational week, had no additional systemic disease, did not use medication, had no fetal chromosomal or structural abnormalities and delivered within 24-48 hours of hospitalization. RESULTS: The mean age of preeclamptic pregnant patients was 29.26±7.15 years, the mean gestational week was 35.6±2.8, and the mean BMI was 31.3±4.9. Twenty (40%) of 50 preeclamptic patients had severe preeclampsia. The mean decrease in systolic blood pressure was 34.6±15.2 mmHg, while the mean decrease in diastolic blood pressure was 22.88±11.68 mmHg (p<0.001). The decrease in systolic and diastolic blood pressure at postpartum 6th week was statistically significant. The mean change in 24-hour urine protein value at postpartum 6th week was 2313.52 ± 2696.48 and the difference was statistically significant (p<0.001). There were 14 patients (28%) with persistent hypertension and 19 patients (38%) with persistent proteinuria. CONCLUSIONS: Although preeclampsia is considered a complication of pregnancy, persistent hypertension, and proteinuria after delivery show us that preeclampsia is a disease that threatens maternal health even after delivery. These women should be followed up long-term period.

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“…Another study by Shahbazian et al evaluated the efficacy and safety of alendronate in the prevention of bone loss in renal transplant recipients and found that the BMD in patients treated with alendronate increased significantly both at the lumbar vertebrae and femoral neck while it decreased in the placebo group. [17] Jamal et al carried out a secondary analysis of the fracture intervention trial to determine if alendronate had differential effects on BMD and fracture by renal function. [18] They concluded that alendronate is safe and effective among this group of women with reduced renal function.…”

Section: Discussionmentioning

confidence: 99%

Effects of Short Term Alendronate Administration on Bone Mineral Density in Patients with Chronic Kidney Disease

Aggarwal

Jain

Chhabra

et al. 2018

Prilozi

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Background: Osteoporosis is highly prevalent in CKD patients and is characterized by low bone mass leading to decreased bone strength. It is associated with an increased risk of fracture, thus increasing morbidity and mortality. Bisphosphonate administration decreases fracture risk in postmenopausal females with osteoporosis. There are limited studies showing effects of short term alendronate administration on BMD in predialysis osteoporotic patients with CKD. Methods: This study was conducted on fifty adult patients with chronic kidney disease. Patients were divided into two groups. Group A consisted of seventeen patients with CKD stage 3 (eGFR 45-30 ml/min/1.73m2) and Group B comprised thirty three patients with CKD stage 4 (eGFR 30-15 ml/min/1.73m2). The study included male patients between age 18-75 years and premenopausal non pregnant females older than 18 years of age. All the patients were osteoporotic having T score < −2.5 on DEXA scan. The patients were administered 70 mg alendronate tablet once a week for 6 weeks. Renal parameters, parathyroid hormone, calcium, phosphorous and alkaline phosphatase levels were assayed at baseline for 6 months. Serum (iPTH) level (pg/ml) was measured by chemiluminescent immune assay (CLIA) method and serum 25 Hydroxy Vitamin D level (ng/ml) was measured by enzyme linked immunosorbent assay (ELISA) method. Bone Mineral Density (BMD) was measured at baseline for 6 months, by dual energy x-ray absorptiometry at lumbar spine and neck of femur and lowest values were included. The results were obtained for T score, Z score and bone mineral density (g/cm2). Results: The BMD, T score and Z score increased in both groups after 6 months with a statistically significant difference in the treatment group. In Group A, T score, Z score and BMD (g/cm2) increased from −2.60±0.086, −2.13±0.28, and 0.80±0.008 at baseline to −2.57±0.097, −2.11±0.26 and 0.81±0.008 after six months. In Group B, the T score, Z score and BMD (g/cm2) increased from −3.17±0.24, −2.82±0.33 and 0.738±0.03 to −3.16±0.25, −2.66±0.95 and 0.743±0.03 after six months with a statistically significant difference. eGFR decreased in both groups but the difference was statistically non-significant (P>0.05). The serum iPTH levels increased after 6 months in both groups with a statistically insignificant difference. There was an increase in serum calcium and decrease in serum phosphate levels after six months, however the difference was statistically insignificant (p>0.05). The SAP values decreased in both groups after six months with a statistically insignificant difference. The main side-effect in the alendronate group was the occurrence of gastroesophageal reflux symptoms in two subjects. Conclusion: Low-dose alendronate, administered for a limited duration, appears to be well tolerated in CKD patients. The BMD increased in both groups suggesting a bone-preserving effect of alendronate.

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Efficacy and safety of alendronate in the prevention of bone loss in renal transplant recipients

Cited by 5 publications

References 0 publications

Evaluation of the efficacy and tolerability of alendronate versus denosumab in kidney transplant patients with reduced bone mineral density

Evaluation of the efficacy and tolerability of alendronate versus denosumab in kidney transplant patients with reduced bone mineral density

Evaluation of Hypertension and Renal Function in Preeclamptic Women: A Follow-Up Study at 6th Week of Postpartum

Effects of Short Term Alendronate Administration on Bone Mineral Density in Patients with Chronic Kidney Disease

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