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Ibandronate: longer dosing intervals aid fracture healing


Bisphosphonates such as ibandronate are used to lower fracture risk in people with various bone diseases, including osteoporosis and metastatic bone disease. A patient taking bisphosphonates who sustains a fracture can, however, experience slower fracture remodelling with persistence of larger, more immature callus at the fracture site. Manabe et al. sought to clarify the effect of different dosing regimens of ibandronate on fracture healing using rats with an induced femoral osteotomy.

Three treatment groups and a control group were studied over an 18-week period. Controls received no treatment; the DAY group received 5 μg/kg ibandronate every weekday for 6 weeks; the I-3 group received 75 μg/kg every 3 weeks and the I-6 group received 150 μg/kg every 6 weeks. At 18 weeks, fracture healing had taken place in the control group and the I-6 group, but rats who had received more frequent ibandronate dosing still had fracture lines. All ibandronate-treated animals developed large calluses around their fractures, which reduced in size between week 6 and week 18.

Editor's comment: In clinical practice, the use of bisphosphonates with a longer dosing period is desirable and the efficacy of ibandronate when given once a month has been clearly demonstrated. It is reassuring that this study echoes what has previously been seen with zoledronate, confirming that longer bisphosphonate dosing intervals have less impact on fracture repair.

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