• 한국임상약학회지
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• 제18권2호
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• pp.114-119
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• 2008

Alendronate is a bisphosphonate that selectively inhibits osteoclast-mediated bone resorption. Dosing convenience is an important element for the enhancement of patient compliance and the effective management of osteoporosis. The purpose of this study was to compare the effectiveness and compliance among alendronate pharmaceutical products (oral once-weekly alendronate 70 mg, daily alendronate 10 mg, and once-weekly alendronate 70 mg with Vitamin $D_3$ 2800 IU) in terms of the change in bone mineral density (BMD), biochemical markers, and compliance estimates. A retrospective chart review was conducted in patients with osteoporosis who received alendronate 70 mg (Group 1), alendronate 10 mg (Group 2), or alendronate 70 mg with Vitamin D3 2800 IU (Group 3) at the endocrinology department of a hospital in Korea from Jan. 1, 1998 to Mar. 31, 2008. The primary endpoints were the increases in spine antero-posterior BMD T-score and femur trochanter BMD T-score, and the compliance of alendronate products. Secondary endpoints included changes in bone turnover-related biochemical markers including bone-specific alkaline phosphatase, urinary N-terminal telopeptides (NTX) and osteocalcin, and in serum vitamin $D_3$ concentration. There was no statistical difference in the BMD increase among the three alendronate products; spine BMD T-score increased by $0.49{\pm}0.52$, $0.39{\pm}0.48$ and $0.50{\pm}0.41$, and femur trochanter BMD T-score by $0.29{\pm}0.42$, $0.21{\pm}0.53$ and $0.24{\pm}0.22$ in Group 1, 2 and 3, respectively. With respect to the increases in femur trochanter BMD T-score and the decreases in NTX and osteocalcin, 70 mg once-weekly group was remarkably superior to 10 mg daily group (p < 0.05) The compliance of 70 mg once-weekly group was significantly higher than that of 10 mg daily treatment group (p < 0.001). In conclusion, all three alendronate treatment groups were equivalent in effectiveness, and the compliance of 70 mg once-weekly group was better than that of 10 mg daily treatment group.

• Childhood Kidney Diseases
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• 제8권1호
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• pp.33-42
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• 2004

목 적 : 소아 신증후군에서 스테로이드 장기투여에 따른 대사성 골질환은 흔한 합병증 중의 하나이다. 저자들은 성인에서의 스테로이드 유발성 골다공증 치료에 유효한 bisphosphonate(alendronate)를 투여하여 소아 신증후군에서 스테로이드 유발 대사성 골질환에 대한 치료효과에 대해 전향적으로 평가하고자 하였다. 방 법 : 신증후군 이환 기간이 2년된 5-8세의 환자 58명에게 DEXA로 골밀도를 측정하여 요추 골밀도가 Z-score -1 이하인 환아 30명(51.7%)을 대상으로 선정한 후 이들을 alendronate 주 1회 투여군, calcitriol 투여군, 약제 비투여군등의 세 군으로 분류하여 1년간 연구하였다. 치료 6개월, 1년에 요추 L1-L4 골밀도를 측정하였고 치료 전과 치료 1년 후 생화학적 검사를 측정하였다. 각 군간 평균 연령, 기저 요추 골밀도, 스테로이드 축적량, 골밀도% 변화율, 요추 골밀도 Z-score를 측정 분석하였다. 결 과 : 총 30명 환자에서 기본 요추 골밀도 측정시 환아의 나이는 $7.4{\pm}1.7$세였고 신증후군 이환기간은 $2.2{\pm}1.2$년이었다. Z-score로 진단된 골밀도 감소증은 23명(76.7%), 골다공증은 7명(23.3%)이었다. 각 생화학적 변수들은 치료 전후로 차이가 없었으며, 군 간에도 유의한 차이가 없었다(P>0.05). 빈번 재발형 신증후군과 스테로이드 의존형 신증후군은 22명(73.3%)으로 드문 재발형 신증후군 8명(26.6%)에 비해 대사성 골질환의 빈도가 높았다. 골밀도 변화율은 alendronate 군에서 치료 1년에 8.56%였고, calcitriol군은 5.79% 증가를 보였으며, 비투여군은 1.9%증가를 보였다. Z-socre 변화는 alendronate 군과 calcitriol 군에서만 호전되었고, 비투여군에서는 감소하였다. 골밀도 증가율은 각 군간 유의한 차이를 보였지만(P=0.0002), alendronate 군과 비투여군, calcitriol 군과 비투여군 간에 있었고(P<0.05), alendronate 군과 calcitriol 군간에는 유의한 차이가 없었다. Alendronate 투여시 약복용을 중단할 만큼의 심각한 부작용은 발현되지 않았다. 결 론 : 소아 신증후군 환자에서 고용량의 스테로이드를 투여해야 하는 경우 대사성 골질환의 발생 위험이 높기 때문에 정기적인 골밀도 측정이 필요하며, 그 평가 도구로는 요추 골밀도 Z-score가 유용함을 알 수 있었다. 또한 신증후군 환아의 스테로이드 유발 대사성 골질환에서 alendronate 주 1회 경구투여는 요추 골밀도를 증가시키는 효과적인 치료법이었다.

• Toxicological Research
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• 제20권3호
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• pp.281-292
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• 2004

The purpose of this study was to assess the single and 5 week oral dose toxicity of calcitriol and alendronate combination (1 : 10,000) treatment for osteoporosis or Paget's disease in male and female rats. In single dose oral toxicity study, the values of $LD_{50}$ of calcitriol and alendronate mixture were 750.075 mg/kg in male rats and 775.0775 mg/kg in female rats, respectively. Body weight and food consumption were continuously increased after adminstration of calcitriol and alendronate mixtures, and there was no significant changes in body weight and food consumption in all groups. In five-week oral toxicity study of calcitriol and alendronate mixture at a dose of 0.2 $\mu\textrm{g}$ + 2 mg, 1 $\mu\textrm{g}$ + 10 mg, 5 $\mu\textrm{g}$ + 50 mg and 25 $\mu\textrm{g}$ + 250 mg, respectively, there was no mortality, abnormal behavior and appearance in all groups throughout the administration period (5 weeks) and recovery period (2 weeks). Dose-dependent changes in parameters of urinalysis and hematological analysis were not observed in male and female rats treated with calcitriol and alendronate mixtures. All the values of the parameters appeared to be in the normal range. These data indicate that both calcitriol and alendronate are drugs having low toxicity in rats. NOAEL of calcitriol and alendronate mixtures were 50.005 mg/kg in 5-week oral toxicity.

• Restorative Dentistry and Endodontics
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• 제26권4호
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• pp.285-295
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• 2001

The objective of this study was to investigate the inhibitory effect of taurine and alendronate on the osteoclast differentiation. Osteoblasts and bone marrow cells from 1-2 day old mouse were co-cultured in 10% fetal bovine serum - minimal essential media (FBS-MEM). Osteoclast differentiation was induced by adding the sonicated extracts of Porphyromonas gingivalis (P.gingivalis). Osteoclasts were identified using tartrate resistant acid phosphotase staining (TRAP). Alendronate of 10$^{-7}$, 10$^{-6}$, 10$^{-5}$M and taurine of 500, 1000, 1500$\mu\textrm{g}$/ml were added respectively. The cytotoxic effects of alendronate and taurine were examined using MTT(3-(4,5-dimethylthiazol -2-yl-2,5-diphenyltetrazo- lium bromide) method. After culturing with the sonicated extracts of P.gingivalis, the amounts of IL-6 in the culture supernatant were measured and compared using the ELISA method. The results were as follows : 1. Osteoclasts were differentiated at the concentration of 0.01~0.1$\mu\textrm{g}$/ml sonicated extracts of P.gingivalis. (P<0.05). 2. Alendronate inhibited osteoclasts differentiation at the concentration of 10$^{-5}$ M when the concentration of sonicated extracts of P.gingivalis was 0.01$\mu\textrm{g}$/ml. 3. Taurine inhibited osteoclasts differentiation at the concentration of 1500$\mu\textrm{g}$/ml when the concentration of sonicated extracts of P.gingivalis 0.01$\mu\textrm{g}$/ml. 4. In cytotoxic test (MTT test), no cytotoxic effect was evident in all concentrations of alendronate and taurine. 5. Taurine (10$^{-5}$M) and alendronate(1500$\mu\textrm{g}$/ml) did not change the amounts of IL-6 induced by sonicated extracts of P.gingivalis significantly.

• Journal of Periodontal and Implant Science
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• 제34권4호
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• pp.733-746
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• 2004

Bisphosphonates는 파골세포에 의한 골흡수를 방지하는 물질로 알려져 있으며 임상에서 널리 쓰이고 있다. 그 중 Alendronate는 Aminobisphosphonates의 한 종류로 non-aminobisphosphonates인 etidronate보다 100-1000배 더 강한 효과를 보이는 것으로 알려져 있다. 본 실험의 목적은 백서두개골 결손부의 골재생을 실험모델로 하여 alendronate의 국소투여 효과를 알아보는 것으로 액체의 흡수성과 골전도성이 우수한 것으로 알려진 collagen membrane을 사용하여 결손부 양측에 alendronate와 physiologic saline을 각각 적용하여 1주, 2주, 4주의 조직학적 치유양상, 파골세포활성도, 경도를 평가하였다. 조직학적 치유양상은 1주째 collagen membrane에 의한 염증성 침윤이 나타났으며 2주째부터 골성회복이 관찰되었고 4주째 완전한 골성회복을 보여 각주별 실험군, 대조군 공히 유사한 양상을 보였고 실험에 사용한 $200{\mu}g$의 용량은 조직학적으로 관찰할만한 골재생의 향상을 위해서는 부족한 용량으로 사료되는 바이다. TRAP(+) cell은 1주째 대조군에 비해 실험군에서 유의하게 적은 수를 보였으며(p<0.01) 2주와 4주째는 유의한 차이를 나타내지 않았고 경도측정에서는 2주째 대조군에 비해 실험군에서 유의하게 높은 경도를 보였으며 4주째 유의한 차이를 나타내지 않았다(p<0.05). 이상의 실험에서 alendronate는 골조직 치유과정의 초기에 파골세포의 활성도와 경도에 다소 영향을 미친 것으로 사료되며 향후 골조직 재생을 위한 임상적용에 응용을 위해서는 치유과정을 더욱 향상시킬 수 있는 추가적인 연구가 필요하리라 사료된다.

• Imaging Science in Dentistry
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• 제38권1호
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• pp.29-37
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• 2008

Purpose: The aim of this study was to observe the bony change in the OVX rat longitudinally and to study the alendronate effect. Materials and Methods: Eighteen Sprague-Dewley rats, eight-week old each, were randomly assigned into three groups: one of those sham-operated (N=4), the other two were OVX: saline-treated (N=7) and alendronate-treated group (N=7). The saline-treated group was administered with saline solution (0.1mL/100g) daily, while the alendronate-treated group was given alendronate (1mg/kg, Sigma-Aldrich Corp. Korea) daily. Micro-CT scannings of the lumbar were consecutively done at baseline, at 3-week intervals during 9 weeks. Two and three dimensional bony analysis were done. Bone mineral density (BMD) was measured with Piximus (GE Lunar Co. USA). The average values of these three methods were compared with each group. Results: After 6 weeks the BMD of the OVX group showed lower tendency than that of sham group. After 6 weeks many 3D parameters of micro-CT showed higher values in the OVX-alendronate group compared with the OVXsaline group. Most 2D bony parameters were higher in the OVX-alendronate group compared with the OVX-saline group at 9 weeks. Conclusion: This study showed low BMD of the OVX group after 6 weeks and showed the effect of alendronate on the BMD and bony structures of ovariectomized rats. This study also showed usefulness of in vivo micro-CT in monitoring individual bone changes over time.

• 폴리머
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• 제33권3호
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• pp.237-242
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• 2009

알렌드로네이트의 생체이용률을 높이고 경구복용시 발생하는 부작용을 해소하고자 경피약물전달시스템에 전기이온영동법, microneedle 등을 적용하여 in-vitro 시험 후 약물전달량을 HPLC-Flu를 이용하여 조사하였다. 전기이온영동시험을 위해 사용된 약물 패취는 UV중합법으로 합성하였으며, 이때 패취에 함유된 알렌드로네이트의 량은 $5.0\;mg/cm^3$이었다. 0.25, $0.50\;mA/cm^2$의 전류를 인가한 경우, 약물전달량은 각각 $0.80{\pm}0.03$와 $2.00{\pm}0.02{\mu}g$이었다. microneedle로 전처리 후의 전달량은 각각 $70.65{\pm}0.37$와 $162.23{\pm}0.40{\mu}g$으로 증가했다. 경피약물전달용 알렌드로네이트 패취의 생체적 합성 평가는 ISO 10993에 따라 시험하였다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권6호
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• pp.397-402
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• 2009

The purpose of this study is to investigate the effects of alendronate and pamidronate on proliferation and the alkaline phosphatase activity of human bone marrow derived mesenchymal stem cells and to relate the results with bisphosphonate related osteonecrosis of the jaw(BRONJ). With the consent of patients with no systemic disease and undergoing iliac bone graft, cancellous bone was collected to obtain human bone marrow derived mesenchymal stem cells through cell culture. 96 well plate were prepared with a concentration of $10^4$cell/ well. Alendronate and pamidronate were added to each well with the concentration of $10^{-6}M$, $10^{-8}M$ and $10^{-10}M$, respectively. Then proliferation capacity of each well was evaluated with the cell counting kit. 24 well plates were prepared with a concentration of $10^5$cell/ml/well and with the bone supplement, alendronate and pamidronate were added with the concentration of $10^{-6}M$, $10^{-8}M$ and $10^{-10}M$, respectively on each plate. The plates were cultured for either 24 or 72 hours. Then the cells were sonicated to measure the alkaline phosphatase activity and protein assay was done to standardize the data for analysis. As the concentration of alendronate or pamidronate added to the culture increased, the proliferation capacity of the cells decreased. However, no statistical significance was found between the group with $10^{-10}M$ of bisphophonate and the control group. Pamidronate was not capable of increasing the alkaline phosphatase activity in all trials. However, alkaline phosphatase activity increased with 24 hours of $10^{-8}M$ of alendronate treatment and with 48 hours of $10^{-10}M$ of alendronate treatment. Cell toxicity increased as the bisphosphonate concentration increased. This seems to be associated with the long half life of bisphosphonate, resulting in high concentration of bisphosphonate in the jaw and thus displaying delayed healing after surgical procedures. Alendronate has shown to increase the alkaline phophatase activity of human bone marrow derived mesenchymal stem cells. However, this data is insufficient to conclude that alendronate facilitates the differentiation of human bone marrow derived mesenchymal stem cells. Further studies on DNA level and animal studies are required to support these results.

• Journal of Pharmaceutical Investigation
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• 제36권2호
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• pp.137-142
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• 2006

A bioequivalence of Daewoong $Alendronate^{TM}$ (Daewoong Pharmaceutical Co., Ltd., Korea) and $Fosamax^{TM}$ tablets (MSD Korea) was evaluated according to the guideline of Korea Food and Drug Administration (KFDA). A single 70 mg dose of sodium alendronate of each medicine was administered orally to 56 healthy male volunteers. This study was performed in a $2\;{\time}\;2$ crossover design. Concentrations of alendronate in the urine were monitored by a high-performance liquid chromatography (HPLC). $A_{et}$ (cumulative urinary excreted amount from time 0 to last sampling interval) was calculated by the accumulation of the urinary excreted alendronate. $U_{max}$ (maximum urinary excretion rate) and $T_{max}$ (time to reach $U_{max}$) were compiled from the urinary excretion rate - time data. Analysis of variance was performed using logarithmically transformed $A_{et}$ and $U_{max}$. No significant sequence effect was found for all of the bioavailability parameters. The 90% confidence intervals of the $A_{et}$ and $U_{max}$ for Daewoong $Alendronate^{TM}/Fosamax^{TM}$ were 0.89-1.12 and 0.82-1.02, respectively. This study demonstrated the bioequivalence of Daewoong $Alendronate^{TM}$ and $Fosamax^{TM}$ with respect to the rate and extent of absorption.

• Journal of Periodontal and Implant Science
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• 제31권2호
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• pp.389-400
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• 2001

Previous studies have demonstrated an increase in bone mass and density with the use of bisphosphonate in osteoporosis. This agent acts as an inhibitor of osteoclastic activity, and results in increase of net osteoblastic activity. Currently, it has been reported that bisphosphonate has direct effect on osteoblast. This study was designed to evaluate the effect of alendronate on bone regeneration in defect of rat calvaria. The animals used for these experiments were 48 male rats, over 6-8 weeks old. They were divided into three groups according to the dose of alendronate($MK-217^{(R)}$, Merck, USA) administered. After the calvarial defects were surgically created, the rats received a peritoneal alendronate(0.25mg/kg) in group I, a peritoneal alendronate(1.25mg/kg) in group II, and a peritoneal normal saline injection in the control group. Three and six weeks later, blood was sampled and evaluated for alkaline phosphatase activity. The animals were sacrificed for histological observation and histometric analysis of the level of bone formation. The alkaline phosphatase activity was similar in three groups at 3 weeks of experiment. The activity at 6 weeks increased more than twice, compared to 3 weeks, and was slightly higher in group I than the other two groups. In histological observation, all the groups at 3 weeks, osteoblast rimming and new bone formation were observed along the defect margin. At 6 weeks, the defect was almost closed with new and more mature bone, but new bone is thinner than original bone in the central portion of defect. In histometric analysis, group I and II at 3 weeks showed significantly greater new bone formation than the control, and all the groups at 6 weeks showed similar amount of bone formation. These result suggest that alendronate administration in the dose of 0.25mg/kg and 1.25mg/kg promote osseous regeneration.