Less frequent dosing improved bisphosphonate compliance.(Gynecology)

SEATTLE -- Monthly dosing of the bisphosphonate ibandronate appears to be just as effective as daily dosing, according to the findings of a controlled study presented at the annual meeting of the American Society for Bone and Mineral Research.

Such findings are welcome, given that compliance with bisphosphonate regimens tends to be challenging.

In addition to causing esophagitis, the drugs require long fasts before and after they are taken. Prescribing a bisphosphonate that requires monthly, rather than daily, dosing could potentially greatly improve compliance, noted Paul D. Miller. M.D., director of the Colorado Center for Bone Research in Lakewood, Colo.

Dr. Miller presented a randomized, blinded study comparing three different doses of oral ibandronate given monthly with the standard dose given daily. The monthly regimens consisted of two 50-mg doses (328 patients), a single 100-mg dose (311 patients), or a single 150-mg dose (320 patients).

All three of the monthly regimens were at least equivalent to the standard 2.5-mg daily dose regimen at improving bone mineral density over 1 year of treatment, he said in a poster presentation.

In the 318 osteoporotic women treated with daily ibandronate, lumbar spine density increased a by a mean of 4%. All three of the monthly regimens produced similar increases, with the 150-mg dose increasing lumbar spine density by a mean of 4.5%.

Density measurements at the total hip and hip trochanter showed greater mean increases with the monthly dosing compared with daily dosing. Total hip density increased by a mean of 2% in the daily group, compared with 3% in the group taking 150 mg/mo.