EFFICACY AND SAFETY OF CYCLICAL ETIDRONATE THERAPY IN THE LONG-TERM TREATMENT OF OSTEOPOROSIS

Postmenopausal osteoporosis is a chronic medical condition that requir es long-term treatment such as oestrogen, calcitonin, or bisphosphonat es. Discontinuation of the first two agents is followed by a prompt lo ss of bone mass. Long-term administration of oral bisphosphonates, how ever, has been associated with maintenance or augmentation of bone mas s for extended periods of time even after discontinuation of the treat ment. Ongoing clinical trials, studying the efficacy and safety of int ermittent cyclical therapy with etidronate (ICT-etidronate), show that 400 mg/day for 14 days every 3 months is effective, well tolerated an d safe. Severe oesophagitis or oesophageal ulcers are simply not seen with long-term ICT-etidronate, nor is there any histological evidence of osteomalacia when comparing pretreatment to post-treatment serial b one biopsies. Since the number of new vertebral factures is reduced in patients who maintain or increase their bone mass, it is probable tha t bisphosphonates improve bone quality in addition to their proven rol e of inhibiting bone resorption. Both doctors and patients need to be assured that chronic administration of any drug is justified, safe, ef fective and worth the cost. It would appear that ICT-etidronate, presc ribed for the treatment of postmenopausal osteoporosis, fulfills these criteria. Osteoporosis impacts a large proportion of the population, and ICT-etidronate could become the most cost-effective and safe thera py for this devastating disease in the aging population.