BACKGROUND: Bisphosphonates form the mainstay of treatment in osteoporosis; however, current adherence with therapy is inadequate. Problems with adherence are thought to be linked to several factors, including frequency of dosing and bisphosphonate-associated intolerability. For non adherent patients, less frequent dosing may be desirable, because the frequency with which strict and inconvenient dosing procedures must be followed is reduced. OBJECTIVES: A new nitrogen-containing bisphosphonate, ibandronate, offers sustained efficacy, with an extended between-dose interval. The molecular characteristics of ibandronate that support extended dosing are described, and trial outcomes for oral and intravenous ibandronate are summarized, in the context of other available bisphosphonates, based on the results of a search of MEDLINE publications (January 1975-December 2005). Relevant safety issues are discussed. CONCLUSION: Awareness of the scientific basis, published trial findings, and clinical implications associated with a once-monthly bisphosphonate can guide treatment decisions and inform communications with patients.
BACKGROUND:Bisphosphonates form the mainstay of treatment in osteoporosis; however, current adherence with therapy is inadequate. Problems with adherence are thought to be linked to several factors, including frequency of dosing and bisphosphonate-associated intolerability. For non adherent patients, less frequent dosing may be desirable, because the frequency with which strict and inconvenient dosing procedures must be followed is reduced. OBJECTIVES: A new nitrogen-containing bisphosphonate, ibandronate, offers sustained efficacy, with an extended between-dose interval. The molecular characteristics of ibandronate that support extended dosing are described, and trial outcomes for oral and intravenous ibandronate are summarized, in the context of other available bisphosphonates, based on the results of a search of MEDLINE publications (January 1975-December 2005). Relevant safety issues are discussed. CONCLUSION: Awareness of the scientific basis, published trial findings, and clinical implications associated with a once-monthly bisphosphonate can guide treatment decisions and inform communications with patients.