Lege Artis Medicinae

[IBANDRONATE IN THE TREATMENT OF POSTMENOPAUSAL OSTEOPOROSIS]

LAKATOS Péter

OCTOBER 19, 2008

Lege Artis Medicinae - 2008;18(10)

[Postmenopausal osteoporosis affects 7-10% of the population of developed countries. During the past decade, a number of new therapeutical modalities have been made available. Among these, bisphosphonates mean the mainstay of medical treatment. Ibandronate belongs to the amino-bisphosphonate group of these drugs. Amino-bisphosphonates act via the mevalonate metabolic pathway, thus, inhibiting protein prenylation. Several clinical studies have shown a significant reduction in the fracture risk of osteoporotic patients treated with ibandronate. This compound can be administered orally once a month or intravenously once in every 3 months. Longer dosing intervals stimulate patient compliance, and consequently increase efficacy and cost effectiveness.]

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[The ONTARGET/TRANSCEND study]

MATOS Lajos

Lege Artis Medicinae

[VERTIGO IN NEUROLOGICAL DISEASES]

FAZEKAS András

[Peripheral and central vestibular syndromes are characterized by the combination of the four symptoms such as: vertigo, nystagmus, imbalance and nausea. Vertigo is the disturbance of the cortico-spatial orientation. Nystagmus is regarded as a secondary symptom caused by direction specific disequilibrium of the vestibulo- ocular reflex. Imbalance is caused by the abnormal activation of vestibulo-spinal pathways. Nausea is due to the activation of the medullary vomiting center. It is important that clinicians can establish an adequate diagnosis and differentiate vertigo and dizziness. The author - without the aim of completeness - discusses the types of vertigo caused by the most important disorders of the central nervous system, emphasizing the role of general practitioners in the diagnostic and therapeutic algorhytm.]

Lege Artis Medicinae

[Recent Debates Concerning Euthanasia and Palliative Care ]

HEGEDÛS Katalin

Lege Artis Medicinae

[Sorafenib in advanced hepatocellular carcinoma]

NEMESÁNSZKY Elemér

Lege Artis Medicinae

[ANTI-VEGF THERAPY WITH BEVACIZUMAB IN BREAST CANCER]

TÓTH Judit, GONDA Andrea, SZÁNTÓ János

[The growth of new blood vessels, angiogenesis is important for tumour progression and metastasis. Vascular endothelial growth factor (VEGF) plays multiple roles in cancer development. Due to it the VEGF seems to be an optimal therapeutic target in breast cancer therapy. The plasma level of this growth factor is highest early in disease suggests that anti-VEGF agents may provide their greatest benefit in firts-line chemotherapy with metastatic breast cancer (MBC). A phase III trial, E2100 evaluated weekly paclitaxel with or without bevacizumab (Avastin), the specific humanised anti-VEGF monoclonal antibody in patients with previously untreated locally recurrent or MBC, doubling of progressionfree survival for all patient subgroups. Bevacizumab is generally well tolerated. The most common adverse events observed in trials hypertension, proteinuria, and wound-healing complications, most of which are grade 1-2 in severity. The registration of bevacizumab for MBC therapy brings new hope for patients. Novel approach of bevacizumab for MBC would be combination chemotherapy and different targeted therapies. Phase III clinical trials of bevacizumab are ongoing in different stages in different settings.]

All articles in the issue

Related contents

LAM KID

[Practical questions regarding the use of teriparatide]

TAKÁCS István

[Teriparatide has become one of the most important drug in the treatment of osteoporosis in Hungary. Although this is not a new drug, a number of questions arise regarding its use in everyday practice. When should we use it as first-line treatment? When should we change the used therapy to teriparatide? What kind of effect can we expect after the start of teriparatide therapy? What are the potential side effects? Financing rules limit, but do not fully control our therapeutic decisions, as these are mostly based on scientific data. In this review, we summarise new and older scientific data regarding teriparatide from practical aspects.]

LAM KID

[Everyday decisions regarding osteoporosis treatment]

TAKÁCS István

[Efficient, new medicines as well as recent scientific results have substantially changed the options and daily practice of osteoporosis treatment. Besides the indicated duration of therapies, their indication has also changed in several key points, and the range of possibilities for switching therapies have expanded. Despite the availability of a steadily increasing number of data, large-scale studies do not always help making therapeutic decisions, so we have to rely on professional protocols and our own experience, as well as on logical thinking. Moreover, we also have to observe financial regulations. This summary is intended to serve as a guideline for the most important decision situations from the initiation of therapy until its cessation.]

LAM KID

[Vertebroplasty and kyphoplasty in the clinical practice]

SZÖLLŐSI Balázs, JAKAB Gábor

[Osteoporosis affects about 600 thousand women and 300 thousand men in Hungary. The fractures give the illness its significance, among them 30-40 thousand vertebral fractures occur annually. One fifth of the patients suffering from vertebral compression fracture (VCF) sustaines an other VCF within a year. The intense pain can not always be controlled under conservative care and an efficient and fast intervention is needed to restore the quality of life of the patients. The cement augmentation (vertebroplasty or kyphoplasty) may help in days. The authors wish to present for the colleagues the details of indication, technical questions of the procedures and their complications based upon the data of numerous operated cases. They emphasize that osteoporotic patients sustained a VCF need complex care and nurture. They also mention that the danger of fracture of a neighbouring vertebra is increased due to the rigidity of the cemented one.]

LAM KID

[Osteoporotic patient’s use of prescription drugs - pilot study]

BATKA Gábor, SZENTANDRÁSSY Andrea Éva, SZEKERES László

[BACKGROUND - In Hungary, the number of the highest mortality hip fractures is between 12 000-15 000 per year. The cost of treating hip fractures is several times higher than that of preventive medical therapy. Thus, the compliance of patients with osteoporosis is of great importance. METHODS - Using the informatical database of St. András Rheumatology Hospital at Héviz, we collected one year’s prescription drugs for osteoporosis and compared them with the number of drugs obtained by the patients, determined from National Health Insurance data. RESULTS - In general, the patients obtained 75% of prescription drugs. From the 4354 boxes of prescribed antiporotics, 3637 contained bisphosphonate (not considering vitamin D and calcium). Within this group, 88% of combination preparations were obtained, which is a greater ratio than that of non-combination bisphosphonates (84%). CONCLUSIONS - On the basis of our results, we posit that prescription of a combination preparation somewhat improves the patients’ compliance. The low concordance of vitamin D and calcium preparations is worrying.]

LAM KID

[Association between osteoporosis and nutrition during the history of human evolution]

KISS Zoltán, KISS István, JÓZSA László

[From the Palaeolithic age to the twentieth century, nutritional habits as well as the quality and composition of nutritients changed dramatically. The protein-based calorie intake of former Homo species had been replaced by a carbohydrate-based nutrition since the Neolithic revolution (the transition to agriculture). The start of food production also changed the range of nutrients and the start of sedentary lifestyle. At the same time, approximately five thousand years ago osteoporosis appeared. In this paper, the authors give a short review of eating habits and foods of early Homo species in the Palaeolithic Age and of Homo sapiens in Neolithic Age, Antiquity, Middle Ages and Modern Age, and discuss the possible relationship of nutrition and osteoporosis.]