Ibandronic acid
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Ibandronic acid is a bisphosphonate medication used in the prevention and treatment of osteoporosis and metastasis-associated skeletal fractures in people with cancer.[1] It may also be used to treat hypercalcemia (elevated blood calcium levels). It is typically formulated as its sodium salt ibandronate sodium.Template:Medical citation needed
It was patented in 1986 by Boehringer Mannheim and approved for medical use in 1996.[2]
Medical uses
Ibandronate is indicated for the treatment and prevention of osteoporosis in post-menopausal women.[3] In May 2003, the US Food and Drug Administration (FDA) approved ibandronate as a daily treatment for post-menopausal osteoporosis.Template:Medical citation needed The basis for this approval was a three-year, randomized, double-blind, placebo-controlled trial women with post-menopausal osteoporosis.Template:Medical citation needed Each participant also received daily oral doses of calcium and 400IUs [international units] of vitamin D.Template:Medical citation needed At the study's conclusion, both doses significantly reduced the occurrence risk of new vertebral fractures by 50–52 percent when compared to the effects of the placebo drug.Template:Medical citation needed
Ibandronate is efficacious for the prevention of metastasis-related bone fractures in multiple myeloma, breast cancer, and certain other cancers.[4]
Adverse effects
In 2008, the US Food and Drug Administration (FDA) issued a communication warning of the possibility of severe and sometimes incapacitating bone, joint or muscle pain.[5] A study conducted by the American Society of Bone and Mineral Research concluded that long-term use of bisphosphonates, including Boniva, may increase the risk of a rare but serious fracture of the femur.[6] The drug also has been associated with osteonecrosis of the jaw, a relatively rare but serious condition.[7]
Pharmacology
Mechanism of action
Nitrogen containing bisphosphonates, which include ibandronate, pamidronate and alendronate exert their effects on osteoclasts mainly by inhibiting the synthesis of isoprenoid lipids such as isopentenyl diphosphate (IPP), farnesyl diphosphate (FPP), and geranylgeranyl diphosphate (GGPP) via the mevalonate pathway. These isoprenoids are used in posttranslational modification (prenylation) of small GTPases such as Ras, Rho, and Rac. These prenylated GTPases are necessary for various cellular processes including osteoclast morphology, endosome trafficking, and apoptosis.[8]
| Bisphosphonate | Relative potency |
|---|---|
| Etidronate | 1 |
| Tiludronate | 10 |
| Pamidronate | 100 |
| Alendronate | 100-500 |
| Ibandronate | 500-1000 |
| Risedronate | 1000 |
| Zoledronate | 5000 |
Society and culture
Brand names
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Ibandronic acid is sold under the brand names Boniva, Bondronat, Bonviva, Bandrone, Ibandrix, Adronil, Bondrova, Bonprove, and Fosfonat.
References
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