Differences among bisfosfonates - specificity of risedronate (Actonel®)

Abstract

Bisfosfonati, zlatni standard u terapijskim opcijama za liječenje osteoporoze, inhibiraju razgradnju kosti s relativno malo nuspojava. Rezultat je široka primjena u prevenciji i liječenju osteoporoze. Postoje jasne biokemijske i farmakološke razlike u skupini bisfosfonata. Risedronat se odlikuje relativno umjerenim afinitetom za hidroksiapatit i jakom inhibicijom ključnog enzima farnezil pirofosfat sintetaze (FPPS) u mevalonskom putu. Risedronat (Actonel®) prevenira vertebralne i nevertebralne prijeloma već nakon 6 mjeseci liječenja. Kliničkim ispitivanjima i opservacijskim ispitivanjima dokazano je smanjenje rizika od prijeloma kralježaka i smanjenje rizika od prijeloma kuka. Bolesnici su značajno češće izabirali lijek koji ima pouzdanije dokaze o antifrakturnoj učinkovitosti, u odnosu na način primjene.Bisphosphonates, a gold standard in therapeutic options for the management of osteoporosis, inhibit bone resorption with relatively few side effects. As a result, they are widely used for the prevention and treatment of osteoporosis. There are clear biochemical and pharmacological differences among bisfosfonates group. Risedronate has moderate mineral binding and has a higher inhibition of a key branch-point enzyme farnesyl pyrophosphate synthase (FPPS) in the mevalonate pathway. Risedronate (Actonel®) prevents vertebral and nonvertebral fractures as early as at 6 months of treatment. Clinical trials and observational trials have proved risk reduction of vertebral and hip fractures. Patients remarkably preferred therapy with a proven antifracture efficacy over a dosage frequency

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