臨床整形外科45巻10号

2010年10月発行

誌上シンポジウム 骨粗鬆症診断・治療の新展開

ビスフォスフォネート製剤の新展開

著者： 萩野浩¹

所属機関： ¹鳥取大学医学部保健学科/附属病院リハビリテーション部

ページ範囲：P.901 - P.906

　ビスフォスフォネート製剤は強力な骨吸収抑制作用を有し，骨折予防の観点から最も信頼されている薬剤である．わが国で使用されている4種類のビスフォスフォネート製剤はいずれも椎体骨折発生を有意に抑制する．大腿骨近位部骨折抑制効果は，アレンドロネート，リセドロネートでは証明されているが，エチドロネートでは認められておらず，ミノドロネートは臨床試験が実施されていない．現在，経口剤の投与間隔のさらなる延長のための臨床試験が試みられており，注射製剤(イバンドロネート，アレンドロネート)も開発中である．

参考文献

1) Black DM, Delmas PD, Eastell R, et al:Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. N Engl J Med 356:1809-1822, 2007

2) Black DM, Kelly MP, Genant HK, et al:Bauer DC:Bisphosphonates and fractures of the subtrochanteric or diaphyseal femur. N Engl J Med, 2010 (e-pub ahead)

3) Chesnut IC, Skag A, Christiansen C, et al:Effects of oral ibandronate administered daily or intermittently on fracture risk in postmenopausal osteoporosis. J Bone Miner Res 19:1241-1249, 2004

4) Delmas PD, Adami S, Strugala C, et al:Intravenous ibandronate injections in postmenopausal women with osteoporosis. Arthritis Rheu 54:1838-1846, 2006

5) Emkey R, Koltun W, Beusterien K, et al:Patient preference for once-monthly ibandronate versus once-weekly alendronate in a randomized, open-label, cross-over trial:the Boniva Alendronate Trial in Osteoporosis (BALTO). Curr Med Res Opin 21:1895-1903, 2005

6) Fleisch H:Bisphosphonates in bone disease:2.3 Actions, Academic Press, San Diego. pp34-55, 2000

7) Hagino H, Nishizawa Y, Sone T, et al:A double-blinded head-to-head trial of minodronate and alendronate in women with post-menopausal osteoporosis. Bone 44:1078-1084, 2009

8) 橋本純子：イバンドロネート．Clinical Calcium 17：11-17，2007

9) Kishimoto H, Fukunaga M, Kushida K, et al:Efficacy and tolerability of once-weekly administration of 17.5 mg risedronate in Japanese patients with involutional osteoporosis:a comparison with 2.5-mg once-daily dosage regimen. J Bone Miner Metab 24:405-413, 2006

10) Lyles KW, Colon-Emeric CS, Magaziner JS, et al:Zoledronic acid in reducing clinical fracture and mortality after hip fracture. N Engl J Med 357:nihpa40967, 2007

11) Matsumoto T, Hagino H, Shiraki M, et al:Effect of daily oral minodronate on vertebral fractures in Japanese postmenopausal women with established osteoporosis:a randomized placebo-controlled double-blind study. Osteoporos Int 20:1429-1437, 2009

12) Recker R, Stakkestad JA, Chesnut CH 3rd, et al:Insufficiently dosed intravenous ibandronate injections are associated with suboptimal antifracture efficacy in postmenopausal osteoporosis. Bone 34:890-899, 2004

13) Uchida S, Taniguchi T, Shimizu T, et al:Therapeutic effects of alendronate 35 mg once weekly and 5 mg once daily in Japanese patients with osteoporosis:a double-blind, randomized study. J Bone Miner Metab 23:382-388, 2005

14) Watts NB, Diab DL:Long-term use of bisphosphonates in osteoporosis. J Clin Endocrinol Metab 95:1555-156, 2010

15) Wells GA, Cranney A, Peterson J, et al:Alendronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women. Cochrane Database Syst Rev CD001155, 2008

16) Wells GA, Cranney A, Peterson J, et al:Etidronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women. Cochrane Database Syst Rev CD003376, 2008

17) Wells G, Cranney A, Peterson J, et al:Risedronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women. Cochrane Database Syst Rev CD004523, 2008

18) 米田俊之，萩野　浩，杉本利嗣・他：ビスホスホネート関連顎骨壊死に対するポジションペーパー．J Bone Miner Metab 28(和訳簡略版)，2010