Open-Label Trial: Effect of Weekly Risedronate Immediately After Transplantation in Kidney Recipients

Torregrosa, José-Vicente; Fuster, David; Gentil, Miguel-Ángel; Marcén, R.; Guirado, Luís; Zárraga, Sofía; Bravo, Juan; Burgos, D.; Monegal, Ana; Muxí, África; García, Sagrario

doi:10.1097/tp.0b013e3181dc13d0

Cited by 46 publications

(48 citation statements)

References 15 publications

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“…For example, a recent open-labeled trial of risedronate in 101 kidney recipients reported positive effects on BMD in the risedronate group but did not comment further on sex. 11 There was no clear evidence that risedronate affected sex hormones. In our study, both men and women were hypogonadal at baseline.…”

Section: Discussionmentioning

confidence: 99%

“…3 Although there have been several prospective studies reporting the effects of parenteral 4,5 and oral bisphosphonates [6][7][8][9] on BMD, there are few studies in renal transplant patients using risedronate, a commonly used third-generation aminobisphosphonate, and its effect on BMD and biochemical measures. 10,11 There are no studies of serial histomorphometry in renal transplant recipients using risedronate. We therefore conducted a 12-month prospective, double-blind, placebo-controlled trial to evaluate the effects of weekly risedronate treatment in living-donor recipients on bone histomorphometry, BMD, and bone biochemical measures.…”

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confidence: 99%

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Effect of Risedronate on Bone in Renal Transplant Recipients

Coco¹,

Pullman²,

Cohen

et al. 2012

Journal of the American Society of Nephrology

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Bisphosphonates may prevent or treat the bone loss promoted by the immunosuppressive regimens used in renal transplantation. Risedronate is a commonly used third-generation amino-bisphosphonate, but little is known about its effects on the bone health of renal transplant recipients. We randomly assigned 42 new living-donor kidney recipients to either 35 mg of risedronate weekly or placebo for 12 months. We obtained bone biopsies at the time of renal transplant and after 12 months of protocol treatment. Treatment with risedronate did not affect bone mineral density (BMD) in the overall cohort. In subgroup analyses, it tended to preserve BMD in female participants but did not significantly affect the BMD of male participants. Risedronate did associate with increased osteoid volume and trabecular thickness in male participants, however. There was no evidence for the development of adynamic bone disease. In summary, further study is needed before the use of prophylactic bisphosphonates to attenuate bone loss can be recommended in renal transplant recipients.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Effect of Risedronate on Bone in Renal Transplant Recipients

Coco¹,

Pullman²,

Cohen

et al. 2012

Journal of the American Society of Nephrology

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“…However, treatment is well tolerated in kidney transplant recipients with a GFR.30 ml/min per 1.73 m 2 , with no significant adverse effects compared with placebo/no treatment (30). The key RCTs using bisphosphonates in kidney transplant recipients are summarized in Table 2 (41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52). Most of the studies show that bisphosphonate therapy preserves or increases BMD in the lumbar spine and femoral neck in the early post-transplantation period.…”

Section: Antiresorptive Agentsmentioning

confidence: 99%

Bone Disease after Kidney Transplantation

Bouquegneau

Salam

Delanaye

et al. 2016

CJASN

127

109

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Bone and mineral disorders occur frequently in kidney transplant recipients and are associated with a high risk of fracture, morbidity, and mortality. There is a broad spectrum of often overlapping bone diseases seen after transplantation, including osteoporosis as well as persisting high-or low-turnover bone disease. The pathophysiology underlying bone disorders after transplantation results from a complex interplay of factors, including preexisting renal osteodystrophy and bone loss related to a variety of causes, such as immunosuppression and alterations in the parathyroid hormone-vitamin D-fibroblast growth factor 23 axis as well as changes in mineral metabolism. Management is complex, because noninvasive tools, such as imaging and bone biomarkers, do not have sufficient sensitivity and specificity to detect these abnormalities in bone structure and function, whereas bone biopsy is not a widely available diagnostic tool. In this review, we focus on recent data that highlight improvements in our understanding of the prevalence, pathophysiology, and diagnostic and therapeutic strategies of mineral and bone disorders in kidney transplant recipients.

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“…Dessa forma, há restrição para o uso dessas drogas, pois o paciente pode apresentar uma DMO baixa sem ter uma remodelação óssea aumentada, e os bisfosfonatos poderiam levar ou agravar a baixa remodelação óssea. Além disso, são drogas de efeito acumulativo no tecido ós-seo, restringindo sua indicação a pacientes com DRC I-III T. Os estudos com bisfosfonatos (pamidronato, ibandronato ou risedronato) usados na prevenção ou no tratamento da perda de massa óssea no primeiro ano do TxR apresentam nível de evidência moderado, efeito benéfico, principalmente considerando a região lombar [52][53][54][55] e sem alteração na função do enxerto. Os benefícios do uso dos bisfosfonatos, nos pacientes TxR tardio, ainda são controversos: são estudos pequenos, em diferentes fases de função renal, não mostrando superioridade com relação ao tratamento com Ca + calcitriol.…”

Section: Racionalunclassified