Navegando por Palavras-chave "alendronato"
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- ItemAcesso aberto (Open Access)Calcinose na infância, um desafio terapêutico(Sociedade Brasileira de Reumatologia, 2007-02-01) Castro, Tânia Caroline Monteiro de [UNIFESP]; Yamashita, Edson [UNIFESP]; Terreri, Maria Teresa Ramos Ascensão [UNIFESP]; Len, Claudio Arnaldo [UNIFESP]; Hilário, Maria Odete Esteves [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Calcinosis is a common and debilitating complication of dermatomyositis. It is a hallmark of the disease, occurring mainly in pediatric patients. Little is known about its pathophysiology, and there is no universally recognized treatment. This is a report of two children with juvenile dermatomyositis and severe calcinosis who showed improvement with the use of alendronate and diltiazen in one patient, and intravenous immunoglobulin in the other.
- ItemSomente MetadadadosEfeito do risedronato sobre a densidade mineral óssea de pacientes ambulatoriais com osteoporose previamente tratados com alendronato(Universidade Federal de São Paulo (UNIFESP), 2016-12-08) Mendonca, Leonardo Teixeira de [UNIFESP]; Castro, Charlles Heldan de Moura Castro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: Osteoporosis is the most common bone metabolic disease. There is no evidence of difference in efficacy between oral bisphosphonates. On the other hand, the exchange of a drug by another is common in clinical practice. Objectives: To investigate the reasons associated with switching between oral bisphosphonates and evaluate the response of bone mass and the incidence of vertebral and non-vertebral fracture 12 months after the exchange of medication. Methods: Patients with osteoporosis who have made the exchange of bisphosphonates (alendronate and risedronate) between January 1990 and December 2014 were included in the present study. Data on bone mass measured by DXA and fracture prevalence have been reported. Results: A total of 112 patients were included and most of them were women (95.5%). Mean age was 73.1 years and average time of diagnosis was 13.1 years. About 98% of the women were postmenopausal. All patients were taking Alendronate at the time of exchange for Risedronate. In 91 patients (81.3%) a reason for the exchange of medication was identified: bone loss (59.8%), adverse events (11.6% - mainly gastrointestinal events in 92.3%) and fracture in 10.7%. One year after the exchange, bone densitometry revealed bone loss in 51 patients (45.5%), bone mass maintenance in 34 (30.4%) and bone mass gain in 27 (24.1%). The reason for the exchange between bisphosphonates did not associate with bone mass outcome (gain, loss or maintenance). Similarly, none of the parameters evaluated in this study was predictor of good densitometric response (gain or maintenance). Conclusions: Our findings suggest that the use of risedronate should not be recommended in the scenario of treatment failure or in the presence of adverse events associated with the use of alendronate.
- ItemAcesso aberto (Open Access)The effects of discontinuing long term alendronate therapy in a clinical practice setting(Sociedade Brasileira de Endocrinologia e Metabologia, 2011-06-01) Silva, André Gonçalves da [UNIFESP]; Vieira, José Gilberto H. [UNIFESP]; Kunii, Ilda Sizue [UNIFESP]; Lana, Janaína Martins de [UNIFESP]; Lazaretti-Castro, Marise [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Fleury InstituteOBJECTIVE: To assess bone turnover markers (BTM) and bone mineral density (BMD) after discontinuation of alendronate treatment used for five or more years. SUBJECTS AND METHODS: 40 patients (pt) with post-menopausal osteoporosis treated with alendronate (10 mg/d) for at least five years (Group 1, G1) had their medication discontinued. Group 2 (G2): 25 pt treated with alendronate for at least one year. Group 3 (G3): 23 treatment-naïve osteoporotic pt. BMD was evaluated in G1 and G2 at baseline and after 12 months. Collagen type I cross-linked C-telopeptide (CTX) and procollagen type 1 N-terminal propeptide (P1NP) levels were measured in all pt at baseline, and in G1 and G2 every three months for 12 months. Data were analyzed using ANOVA on ranks and Mann-Whitney tests. RESULTS: Mean BMD values in G1 and G2 did not differ during follow-up. However, 16 pt (45.7%) in G1 and one (5.2%) in G2 lost BMD (P < 0.001). BTM at baseline was not different between G1 and G2, and both were lower than G3. A significant increase in BTM levels was detected in G1 pt after three months, but not in G2. CONCLUSION: Observed BMD loss and BTM rise after alendronate withdrawal imply that bone turnover was not over suppressed, and alendronate discontinuation may not be safe.
- ItemAcesso aberto (Open Access)Linhas escleróticas metafisárias em crianças e adolescentes em uso de alendronato(Sociedade Brasileira de Reumatologia, 2010-06-01) Silva, Érika Cristina Carneiro da [UNIFESP]; Terreri, Maria Teresa Ramos Ascensão [UNIFESP]; Castro, Tania Caroline Monteiro de [UNIFESP]; Barbosa, Cassia Maria Passarelli Lupoli [UNIFESP]; Fernandes, Artur da Rocha Correa [UNIFESP]; Hilário, Maria Odete Esteves [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)INTRODUCTION: Bisphosphonates inhibit bone resorption by interfering with the action of osteoclasts. Among the adverse effects, sclerotic lines observed in the metaphysis of long bones have been described as the main imaging finding in pediatric patients. OBJECTIVE: To evaluate the frequency of radiographic changes caused by alendronate in children and adolescents with low bone density or calcinosis. PATIENTS AND METHODS: We conducted a cross-sectional study with 21 patients who were treated with once-weekly alendronate for at least 10 months. Patients underwent x-rays of long bones before the start of alendronate and approximately one year after its use. RESULTS: Eleven patients (52.3%) had sclerotic lines in the metaphysis of long bones. The most frequent site was the tibia (8/11 patients), followed by the femur (7/11), humerus (6/11), radius (4/11), ulna (3/11), and fibula (2/11). Regression of radiographic changes during the study period (up to 1.1 years after discontinuation of alendronate) was not observed. CONCLUSION: If used carefully, alendronate is safe and radiographic changes have not been shown to be clinically relevant.