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Chapurlat et al. [11], investigated the degree of bone turnover suppression in women who had been on long-term bisphosphonate use (mean duration 6.5 years) by obtaining transiliac bone biopsies and found significantly reduced turnover compared with those not on bisphosphonates.
Creating a less hospitable microenvironment in bone for cancer cell growth through bone turnover suppression, in addition to possible direct anticancer effects of BPs, may be a potential mechanism for the improved DFS observed with ZOL in the AZURE, ABCSG-12, and ZO-FAST trials.
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Studies of intermittent intravenous ibandronate in postmenopausal osteoporotic women have shown a dose-related increase in BMD and bone turnover marker suppression comparable with those obtained with the proven effective oral ibandronate regimen.
Comparison to daily oral risedronate shows that they achieve similar bone turnover marker suppression and BMD increases (Delmas et al 2007a; Delmas et al 2007b).
Bisphosphonates' suppression of bone turnover results in a failure to repair these micro-cracks.
20 There was a greater suppression of bone turnover markers in the patients treated with denosumab compared to zoledronic acid.
Moreover, prolonged use of BPs has recently been associated with severe suppression of bone turnover, alterations in normal collagen cross-linking and matrix heterogeneity, reduced vascularity and decreased cortical bone toughness, as well as a small number of subtrochanteric or diaphyseal femoral fractures.
Oral ibandronate, when administered either daily or intermittently, demonstrates important antifracture efficacy at the spine and hip (50%–60% risk reduction versus placebo), accompanied by significant increases in BMD at the spine and hip, and suppression of bone turnover markers in postmenopausal women (Tankó et al 2003; Chesnut et al 2004; McClung et al 2004; Reginster 2005).
In the present study, we have explored whether administration of ZA in the night, when osteoclast activity is rising, could result in a greater suppression of bone turnover as compared with suppression by the conventional morning administration.
The response to estrogen was greater in high bone turnover patients than in low bone turnover patients.
In conclusion, vital bone volume and bone turnover decreased in the 12-month group compared to the 9-month group.
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