Minodronic acid suppresses gonadotropin-releasing hormone agonist-induced bone remodeling biomarkers: a retrospective pilot study

Abstract

Background: Estrogen deprivation therapy for myoma/adenomyosis decreases bone mineral density and can only be applied in the short term, as temporizing measures in the premenopausal woman.

Objective: To examine the effects of bisphosphonate minodronic acid on markers of bone turnover over a 6-month period in women receiving gonadotropin-releasing hormone agonist (GnRHa).

Methods: We retrospectively analyzed the medical records of 19 premenopausal patients with myoma/adenomyosis, who received GnRHa (leuprolide acetate, 1.88 mg/month or buserelin acetate, 900 µg/day) for 6 months from January 2014 to December 2014. Eight patients concomitantly received minodronic acid 50 mg every month during GnRHa therapy, and 11 treated with GnRHa alone. To compare these data in a case-controlled study, we analyzed an age-matched group of seven (premature or natural) menopausal women treated with minodronic acid. The primary outcome was percent changes in bone turnover markers in urine at 6 months.

Results: In menopausal women group, minodronic acid (50 mg once-monthly) for 6 months decreased urinary deoxypyridinoline (DPD) and cross-linked N-telopeptides of type 1 collagen (NTX). Women receiving a GnRHa had a significant increase in urinary DPD and TNX at 6 months while minodronic acid during GnRHa therapy improved urinary levels of DPD and NTX to near baseline.

Conclusion: Minodronic acid treatment appears to be promising in women with secondary bone loss receiving GnRHa treatment.

Chinese abstract

背景：对绝经前期的子宫肌瘤或子宫内膜异位症患者进行降雌激素治疗会降低骨密度，所以降雌激素治疗只能作为一种姑息手段短期应用。

目的：研究米诺膦酸对于接受大于6个月GnRH-a治疗的患者骨重塑的作用。

方法：回顾性研究2014年1月至2014年12月期间就诊的19名患子宫肌瘤或子宫内膜异位症的绝经前女性的病例资料：她们均接受了6个月的GnRH-a治疗（醋酸亮丙瑞林，每月1.88mg或醋酸布舍瑞林，每天900ug）。其中8名患者在用药期间同时服用米诺膦酸，每月50ug，其余11名患者单独应用GnRH-a。为了进行病例对照研究，在年龄方面进行匹配，我们选取了口服米诺膦酸的7位绝经期女性（包括人工绝经及自然绝经）的病例数据，来比较三组患者治疗6个月时骨重塑的生物标志物水平。

结果：单独应用GnRH-a患者在治疗6个月时血清脱氧吡啶诺林（DPD）及I型胶原氨基末端肽（NTX）水平显著升高，同时应用米诺膦酸组这两种生物标志物水平明显降低至近基线水平。

结论：对于治疗继发于GnRH-a的骨质流失而言，米诺膦酸是一种非常有应用前景的药物。

• Bisphosphonate
• bone turnover markers
• GnRHa-induced bone loss
• minodronic acid

Declaration of interest

The authors report no declarations of interest.