Monthly ibandronate versus weekly risedronate treatment for low bone mineral density in stable renal transplant patients

Abstract

Introduction: Bisphosphonates may aid in treating and preventing bone loss promoted by chronic immunosuppressive treatment and secondary hyperparathyroidism in renal transplant (RT) patients. However, the effectiveness of bisphosphonates is compromised by poor patient compliance. The objective of the study was to compare the effects of once monthly ibandronate with those of weekly risedronate administration on bone mineral density (BMD) and renal function in RT patients.

Patients and methods: Sixty-nine patients were prospectively recruited who were at least 12 months post-RT and were treated with either oral ibandronate 150 mg monthly (n=35) or oral risedronate 35 mg weekly (n=34). At baseline and 1 year, creatinine, calcium, alkaline phosphatase, and i-parathyroid hormone were measured, and BMD was determined by dual-energy X-ray absorptiometry.

Results: Group I consisted of 35 patients (28 women) treated with ibandronate who were of a mean age of 63±12 years. Group II consisted of 34 patients (30 women) treated with risedronate who were of a mean age of 64±10 years. Lumbar BMD was as follows: baseline T-score (group I vs. group II) of -1.7±0.8 versus -1.9±0.8 (P=NS); and annual T-score of -1.3±0.6 versus -1.4±0.8 (P=NS). After 1 year, lumbar BMD improved to reveal a T-score of -1.3±0.6 in the ibandronate group (P<0.01) and -1.4±0.8 in the risedronate group (P<0.01). Femoral BMD was as follows: baseline T-score (group I vs. group II) of -2.1±0.7 versus -2.2±0.6 (P=NS); and annual T-score of -1.8±0.9 versus -1.8±0.8 (P=NS). Cortical bone also improved in both groups, but results were not statistically significant. No changes in renal function and no adverse effects were observed.

Conclusion: In RT patients with low BMD, no difference in effects on BMD, renal function, or adverse effects were observed between monthly oral ibandronate and weekly oral risedronate administration.