Review of ibandronate in the treatment of osteoporosis

Several antiresorptive treatments that reduce the risk of osteoporotic fracture are now available, including bisphosphonates. Ibandronate is a new potent bisphosphonate, currently under development, with unique features. In several animal models of human osteoporosis, it has been shown to inhibit bone resorption and improve bone mechanical properties. Ibandronate is more potent than most current bisphosphonates. Several dosages and schedules have been tested in humans. With the oral daily dose of 2.5 mg, a reduction of 62% in the incidence of vertebral fracture has been demonstrated in a randomised, placebo-controlled trial. In the same trial, a reduction of 50% has been observed - for the first time using a bisphosphonate - with an intermittent regimen (20 mg every other day for the first 24 days, followed by 9 weeks without the treatment). In contrast, another randomised, placebo-controlled trial failed to find a significant reduction in vertebral fracture risk using an dose of 1 mg i.v. every 3 months. Thus, ibandronate can be considered as a promising new option for the treatment of postmenopausal osteoporotic women.