Bisphosphonates from A–Z

List of Indications

Indications for which bisphosphonates are already authorised Osteology

▶

Prevention and treatment of postmenopausal osteoporosis

▶

Prevention and treatment of glucocorticoid-induced osteoporosis

▶

Prevention and treatment of osteoporosis in men

▶

Treatment of Paget’s disease of bone

▶

Prevention of heterotopic ossification

Hematology and Oncology

▶

Hypercalcemia of malignancy

▶

Bone metastases

▶

Osteolyses in multiple myeloma

Clinical Trials have been Successfully Completed, but Bisphosphonates are not yet Officially Authorised for the Following Indications

Osteology, Orthopedic Medicine and Rheumatology

▶

Prevention and treatment of premenopausal osteoporosis

▶

Juvenile osteoporosis

▶

Transplantation osteoporosis

▶

Secondary osteoporoses

▶

Osteogenesis imperfecta

▶

Transient osteoporosis

▶

Bone marrow edema syndrome

▶

Rheumatoid arthritis

▶

Bone pain

▶

Renal osteopathy/osteodystrophy

▶

Complex regional pain syndrome (Morbus Sudeck)

▶

Vanishing bone disease (Morbus Gorham)

▶

Fibrous dysplasia

▶

SAPHO syndrome

▶

Aseptic loosening of prosthesis

▶

Periodontitis

▶

Hyperostosis (e.g., DISH)

▶

Early cases of osteonecroses

▶

Hypercalcemia not associated with malignancy (e.g., inoperable pHPT, sar- coidosis)

Hematology and Oncology

▶

Treatment of osteoblastic bone metastases (e.g. prostatic carcinoma)

▶

Prevention of osteolyses in patients with established bone metastases (e.g. from breast cancer)

▶

Adjuvant therapy for prevention of bone metastases (e.g. from breast cancer)

▶

Prevention of skeletal destruction in multiple myeloma

▶

Antiproliferative therapy in multiple myeloma

▶

Systemic mastocytosis

▶

Bone pain in osteomyelosclerosis

▶

Primary bone tumors and sarcomas with bone metastases

List of Indications in Medical Practice from A–Z

Cardiology Patients on warfarin, long-term therapy Patients on heparin, long-term therapy Chronic heart failure

Heart transplantation

Dentistry Periodontitis (cave: necrosis of jaw bones) Endocrinology Hyperthyroidism

Hyperparathyroidism Diabetes mellitus Cushing’s syndrome Addison’s disease Acromegaly Hypogonadism Klinefelter’s syndrome

Gastroenterology Primary biliary cirrhosis Chronic hepatitis Hepatic cirrhosis

Gastrointestinal operations Crohn’s disease

Chronic pancreatitis Malabsorption syndromes Liver transplantation Geriatrics Immobilisation

Involutional osteoporosis Gynecology Estrogen deficiency

Postmenopausal osteoporosis Metastatic breast cancer Postpartum, after lactation Hysterectomy

Bilateral ovariectomy Hematology Multiple myeloma

Malignant lymphoma Osteomyelosclerosis Hemolytic anemias Aplastic anemia Systemic mastocytosis Eosinophilic granuloma Histiocytoses

Bone pain

Myelogenous osteopathies Bone marrow transplantation Infectiology Tuberculosis

Leprosy AIDS Malaria Chagas’ disease Leishmaniasis Toxoplasmosis Metabolism Hemochromatosis

Oxalosis Hypercalcemia Storage diseases

Nephrology Renal osteopathies/osteodystrophies Chronic hemodialysis

Renal transplantation

Metastatic renal cell carcinoma Hereditary hyperphosphatasia Neurology Antiepileptic drug use

Peripheral paresis

Systemic myopathies, e.g. multiple sclerosis Diabetic neuropathy

Oncology Bone metastases Prevention of metastasis Bone pain

Hypercalcemia of malignancy Chemotherapy-induced osteopathy Bone marrow transplantation Osteology/ Osteoporosis syndrome Orthopedics Paget’s disease of bone

Gorham’s disease Fibrous dysplasia

Aseptic loosening of prosthesis Complex regional pain syndrome Early stage of osteonecrosis

DISH (disseminated idiopathic skeletal hyperostosis) Transient osteoporosis (bone marrow edema syndrome) Fatigue fractures

Giant cell tumor of bone Immobilisation Osteoarthritis Osteochondritis Ankylosing spondylitis Heterotopic calcification

Fibrodysplasia ossificans progressiva Pediatric Medicine Idiopathic juvenile osteoporosis

Osteoporosis of children Immobilisation osteoporosis Osteogenesis imperfecta Storage diseases

Inherited collagen disorders Hypercalcemia of children Physical medicine Osteoporosis

Immobilisation Arthrosis Psychiatry Anorexia nervosa

Depression

Antidepressant drug use

Pulmonology Bronchial asthma (requiring cortisone) Cystic fibrosis

Chronic obstructive pulmonary disorders Sarcoidosis

Tuberculosis

Metastatic lung cancer Lung transplantation Rheumatology Primary chronic polyarthritis

Ankylosing spondylitis Systemic lupus erythematosus Connective tissue diseases Immobilisation

Long-term glucocorticoid therapy SAPHO syndrome

Space medicine Weightlessness-induced osteoporosis Sports medicine Long-distance running and walking

Fatigue fractures Radiation therapy Post-irradiation osteolysis

Surgical trauma- Immobilisation – whole body and regional tology Total endoprosthesis

Toxicology Nicotine Alcohol Heavy metals Aluminum Lithium

Hydrocarbon poisoning Barbiturates

Urology Metastatic prostatic carcinoma Metastatic renal carcinoma

List of Subgroups of Bisphosphonates

Bisphosphonates without Nitrogen

Etidronate Clodronate Tiludronate

Aminobisphosphonates

Pamidronate Alendronate Neridronate

Bisphosphonates with Nitrogen Substitution

Olpadronate Ibandronate

Bisphosphonates with Basic Heterocycles Risedronate

Zoledronate

List According to Different Modes of Action

Incorporation as ATP-analogues (in ATP containing Compounds):

“First-generation” Bisphosphonates

Etidronate Clodronate Tiludronate

Inhibition of the Mevalonate Pathway and Inhibition of Protein Prenylation:

“Second-generation” Bisphosphonates: Inhibition of Dimethylallyl-PP

Alendronate Pamidronate

“Third generation” Bisphosphonates:

Inhibition of Dimethylally-PP and Geranyl-PP

Risedronate Zoledronate Ibandronate

List of Commercial Bisphosphonate Preparations from A to Z

Trade name Bisphosphonate Application Company

Aclasta

®

Zoledronate I.V. Novartis

Actonel

®

Risedronate Oral Procter & Gamble,

Sanofi-Aventis Actonel

®

^{35 mg}

plus calcium

Risedronate/

calcium

Oral Procter & Gamble Sanofi-Aventis

Aredia

®

Pamidronate Oral Novartis

Bondronat

®

Ibandronate Oral and I.V. Roche

Bonefos

®

^Clodronate Oral and I.V. Medac/Schering Bon(v)iva

®

Ibandronate Oral and I.V. Roche/GlaxoSmithKline

Didronel

®

^{Etidronate Oral} Procter & Gamble

Trade name Bisphosphonate Application Company

Didronel-Kit

®

Etidronate/calcium Oral Procter & Gamble, Aventis

Diphos

®

^{Etidronate Oral} Procter & Gamble

Etidronat Jenapharm

®

Etidronate Oral Jenapharm

Fosamax

®

Alendronate Oral MSD

Fosavance

®

Alendronate/Vit.D Oral MSD

Lodronat

®

^Clodronate Oral and I.V. Roche (Austria)

Ostac

®

^Clodronate Oral and I.V. Roche

Skelid

®

Tiludronate Oral Sanofi

Zometa

®

Zoledronate I.V. Novartis

List of Authorised Bisphosphonates from A to Z

Bisphosphonate Trade names

Alendronate Fosamax

®

, Fosavance

®

Clodronate Ostac

®

^{, Bonefos}

®

Etidronate Didronel

®

, Didronel-Kit

®

Ibandronate Bondronat

®

, Bon(v)iva

®

Pamidronate Aredia

®

Risedronate Actonel

®

^{, Actonel}

®

plus calcium Tiludronate Skelid

®

Zoledronate Zometa

®

^{, Aclasta}

®