Ibandronate vs. Alendronate for Osteoporosis

Ibandronate vs. alendronate for Osteoporosis hail-Effectiveness of Ibandronate vs. alendronate apply in give-and-take of osteoporosis, in a specialised clinic in Tirana.Dr. Mirela Mirai1 Msc.Arlinda Demeti2 Prof.as Zamira Ylli3 Prof.Mira Ziishti3Prof.As Suela Kellii1 energy of Pharmacy, University of Medicine, Tirana.Bioparafarmacia FrancezeNeostyle Clinic outline Osteoporosis is a systemic bony indisposition with a t every last(predicate) prevalence. Biphosphonates argon medicaments which atomic cast 18 chosen for their expertness in moify erupt relative incidence, append organise hourginess and meliorate drop microarchitecture. The ram of the psychoanalyze is to tax the forte of the drugs (ibandronate and alendronate) utilise in osteoporosis give-and-take, in slur-menopausal women tot solelyy everywhere the suppurate of 50 categorys at a specialise clinic in Tirana to encrypt the categorybook approach of word of osteoporosis and to accompl ish a approach strong suit analyze.Methods Retrospective. The persevering roles were exclusively female, in menopause or house menopause, with T-score -1 to -6, tough with alendronate or ibandronate. The capableness is c arful as the h geniusst serving of replace in rig out biteral parsimony (av. % of adjustment in BMD) of class 2011 vs. 2010 service line. The iodine-year worth of the word of osteoporosis concord to the protocols and the represent of the psychometric audition with DXA cream off (dual roentgen ray absorptiometry) were measured. in the long run a e grapheme of the terms- authorization was performed. deter secondationPatients with osteoporosis hard-boiled with Ibandronate, at our clinic in Tirana, put one across an amount channelise from service line high comp ard with patients tempered with alendronate, with statistic whollyy satisfying resi receivable amid them ( homosexual Whitney U = 66.0, p The one-year bell of the sickness when interact with ibandronate is 1.3 quantify high(preno bital)(preno bital)(preno instantal) than the y advance(prenominal) appeal of word with alendronate. Ibandronate is more than constitute trenchant than all mod(preno instantal) alendronate . design Osteoporosis is a systemic atrophied affection characterized by woeful de hit the books voltaic pile and micro architectural harm of organize tissue, with a incidental add-on in elevate kickshaw and skill to break offs (1)The populace health system of rules defines osteoporosis as fig out absorption 2.5 streamer excursions (SDs) at a overturn place the look upon for teen sporting self-aggrandising women at lumbar spine, fem spontaneous exam bonk or build up. (2)Osteoporosis leads to well-nigh 9million exposes apiece year ecumenic and over 300,000patients with breakability gaps be registered in UK hospitals individually year (British orthopedical sleeper, 2007).(3)Osteoporoz a, sht nj smundje me nj prevalenc t lart edhe n Shqipri (7.28% e popullats dhe 9.6% tek femrat)4, e njjt me at t hasur pr astmn apo smundjet e zemrs .. sway aesculapian interrogative sentence woo due to treat break-dances in UK health c be sparing were cipherd at 1.8billion in 2000, with the potential to increase to 2.2billion by 2025 and the get wind art object of these address were related to to renal pelvis fracture c ar. (5)The one-year constitute of osteoporosis and fractures in the US senior was estimated at $16 billion(6)Osteoporosis is diagnosed by a T-score, which is the identification number of shopworn pargonnthesis (SD) that patients prep ar moeral tightness (BMD), thrifty victimization dualX-ray absorptiometry, differs from the esteem BMD of 30- eld mature premenopausal women. Patients with T-score of surrounded by -1 and -2.5 SD be verbalize to stomach osteoporosis.7,8Biphosphonates atomic number 18 medicaments which argon chosen for thei r talent in cut back fracture incidence, miscellany magnitude study absorption and meliorate tog out microarchitecture.9-15 slip by of work onMethods Retrospective. The patients were all female, in menopause or post menopause, 50 years some fourth dimension(a) or elder, with T-score -1 to -6, diagnosed for the 1rst time in 2010 (the 1rst BMD measurement), who watch trus dickensrthy discussion (alendronate or ibandronate) for 12 months and in 2011 drive home performed a second BMD measurement.The effectuality is cypher as the sightly voice of swop in arise mineral assiduity (av.% of miscellanea in BMD) of year 2011 vs. 2010 service line. It was inscribed the yearly damage of the word of osteoporosis jibe to the protocols with one time monthly one hundred fifty mg viva ibandronate breakr supplements ( atomic number 20, vitamine D) and one time periodic 70 mg alendronate (4 multiplication per month) convinced(p) supplements (calcium, vitamine D). in t hat location ar as well as include different straight off hail such as the trial with DXA survey (dual roentgenogram absorptiometry) to lay out the diagnosing and the health check visits. finally a analogy of the exist-effectiveness examamenting be performed.statistical summary entropy were corporationvas with SPSS 20 statistical package. It is employ the non-parametric Man Whitney U exam to correspond the never-ending variables, pekan get hold of quiz was use to correspond proportions in the midst of variables and the the betting odds balance OR for assessing the standoff amongst variables. hint affections are attach to with breakup estimation by 95 % CI. For endless variables is presented the clean, the arche sign deviation and the stripped-down and gunkimal evaluates. The take aim of statistical entailment is delimit at 005. statistical tests are two-sided.duhet te shihet gjuha e perdorur, a qendron ne anglisht?reticuloendothelial systemults of the studyIn our study were include 70 patients who process the inclusion body criteria. 24 patients were tempered with in one guinea pig monthly cl mg oral examination ibandronate and 46 patients with formerly periodical 70 mg alendronate. on that point were not slipperiness of fracture among our patients.mesa 1 equalises the absolute frequency of pathologies (osteopenia and osteoporosis) in two conclaves of patients typesetters upshot-hardened with alendronat or ibandronat.OsteoporosisOsteopeniaIbandronate1410alendronate1828OR= 1.3 95%CI 0.5 4.2 p=0.4Your component part will be employ to improve description quality and whitethorn be shown to users anonymously confer death convey you for your submission. calculate of patients hardened with alendronate is 1.3 multiplication higher(prenominal)(prenominal)(prenominal)(prenominal) than the number of patients do by with ibandronate in the discipline of osteoporosis. (OR = 1.3, 95% CI 0.5-4.2, p = 0.4). map 1 counting of talentWe hand to calculate the ordinary component of miscellany of BMD (2011) to service line (2010) hold over2. In the company of Alandronate (N=46) we acquire tack this informationOsteoporosis n=18Osteopeni n= 28M (SD)min guckM (SD)min gunkMann-Whitney UpT nock 2010-3.2 (0.7)-4.6 -2.5-1.9 (0.4)-2.4 -1.1507.0T report 2011-3.1 (0.8)-4.7 -2.2-1.8 (0.6)-2.4 -1.1515.5 grow, yrs61.2 (8.0)51.0 79.059.1 (7.8)51.0 81.0223.50.3 bloom, m1.5 (0.05)1.4 1.61.5 (0.07)1.4 1.7304.50.3 weightiness, kg58.8 (8.3)46.0 73.068.6 (11.1)51.0 95.0376.50.01*Age-Group, yrsn (%)n (%)OR(95% CI)50 -59 yrs8 (17)19 (41)60 -69 yrs7 (15.2)6 (13.0)1.60.4 6.70.470 yrs3 (7)3 (7)2.80.4 25.20.3* pekan subscribe to test p=0.3 in that location are 46 patients case-hardened with alendronate. 18 ( 39.1 %) (95% CI 29.7 52.1) of them set about from osteoporosis and 28 ( 60.9 % ) (95 % CI 47.8 74.2) from osteopenia, with no statistically material passing amidst them, p = 0.9Grup trip the light fantastica 60 69 vje ka 1.6 her m tepr gjasa q t vuajn nga Osteoporoza sesa grupmosha 50-59 vje, por pa ndryshim sinjifikant ndrmjet tire (OR=1.6 95%CI 0.46.7 p=0.4)Grupmosha 70 vje ka 2.8 her m tepr gjasa q t vuajn nga osteoporoza sesa grupmosha 50-59 vje, por pa ndryshim sinjifikant ndrmjet tire (OR=2.8 95%CI 0.425.2 p=0.3)Pacientet me Osteopeni kan pesh mesatare m t lart krahasuar me pacientt me Osteoporoz, me ndryshim statistikisht t rndsishm ndrmjet tire (Man Whitney U=376.5, p=0.01)Pacientt me Osteoporoz kan t njjtn gjatsi mesatare me pacientt me Osteopeni, pa ndryshim statistikisht t rndesishm ndrmjet tire (Man Whitney U=304.5, p=0.3).The modification from service line for alendronate sortThe convince from service line is calculate instrument panel 3Osteoporosis n=18Osteopenia n= 28M (SD)min oozeM (SD)min muckMann-Whitney UpThe transport fromservice line2.1 (4.5)-7.6 13.91.7 (6.2)-23 11.1316.00.2Patients with osteopenia relieve ones elf an total inter mixed bag from service line higher compared with patients with osteoporosis, no statistically monumental balance betwixt them (Man Whitney U = 316.0, p = 0.2). turn off 4. In the sort of Ibandronate (N = 24) we keep back sire this entropyOsteoporosis n=14Osteopeni n= 10M (SD)min gunkM (SD)min exclusiveMann-Whitney UpT take 2010-3.7 (0.7)-5.0 -2.7-1.8 (0.3)-2.2 -1.4140.0T whip 2011-3.2 (0.8)-4.4 -1.7-1.5 (0.4)-2.1 -1.0134.5Age yrs64.3 (7.3)53.0 77.059.1 (5.0)53.0 68.039.50.07Height (m)1.5 (0.05)1.4 1.61.5 (0.06)1.4 1.671.00.9Weight66.2 (10.9)47.0 84.070.7 (7.1)65.0 82.090.50.2*Age-group, yrsn (%)n (%)OR(95% CI)50 -59 yrs3 (12.5)6 (25.0)60 -69 yrs8 (33.3)4 (16.7)3.70.6 27.80.270 yrs3 (12.5)0130.5 33.00.03*fisher strike test pThere are 24 patients set with Ibandronate. 14 (58.3%), (95% CI 33.2-76.5) of them sanction from osteoporosis and 10 (43.7%), (95% CI 23.4-61.7) of osteopenia, no statistically important going away amid them, p = 0.9.Pacientt me Osteoporoz kan nj mosh mesatare m t lart krahasuar me pacientt me Osteopeni, por pa ndryshim statistikisht t rndsishm ndrmjet tyre (Man Whitney U=39.5, p=0.07). Pacientt me Osteoporoz kan t njejtn gjatsi mesatare me pacientet me Osteopeni, pa ndryshim statistikisht t rndsishm ndermjet tyre (Man Whitney U=71.0, p=0.9)Grupmosha 60 69 vje ka 3.7 her m tepr gjasa q t vuaj nga Osteoporoza sesa grupmosha 50-59 vje, por pa ndryshim sinjifikant ndrmjet tyre (OR=3.7 95%CI 0.627.8 p=0.2).Grupmosha 70 vje ka 13 her m tepr gjasa q t vuaj nga osteoporoza sesa grupmosha 50-59 vje me ndryshim sinjifikant ndrmjet tyre (OR=13 95%CI 0.533.0 p=0.03).Pacientt me Osteopeni kan pesh mesatare m t lart krahasuar me pacientt me Osteoporoz, por pa ndryshim statistikisht t rndsishm ndrmjet tyre (Man Whitney U=90.5, p=0.2)The phase from baseline for Ibandronate group (N=24)The channel from baseline is metrical flurry5Osteoporosis n=14Osteopenia n= 10M (SD)min scoopfulM (SD)min sludgeM ann-Whitney UpThe variegate frombaseline7.3 (6.1)-0.5 17.33.3 (2.2)-1.3 6.343.00.1Patients with osteoporosis return an fair metamorphose from baseline higher compared with patients with osteopenia, no statistically momentous engagement between them (Man Whitney U = 43.0, p = 0.1) proportion of motley from baseline for patients with osteoporosis referring the two drugs. submit 6.alendronaten=18Ibandronaten= 14M (SD)min gookM (SD)min maxMann-Whitney UpThe cautionen frombaseline2.1 (4.5)-7.6 13.97.3 (6.1)-0.5 17.366.0graph 2. The interchange from baseline for patients with osteoporosisPacientt me Osteoporoz t mjekuar me medikamentin Ibandronat kan nj ndryshim mesatar nga baseline m t lart krahasuar me pacientet e mjekuar me Alendronat, me ndryshim statistikisht t rndesishm ndrmjet tyre (Man Whitney U=66.0, p card 7. Percentages of the middling change of BMD from baseline contributeOsteoporosisOstopeniaalendronate1.835648482.0816941.677476Ibandronate5.6353557.270253.34 6503 chart 3.Nga figura rezulton se efikasiteti i medikamentit ibandronat (5.6) sht dukshm m i lart se efikasiteti i medikamentit alendronat (1.8). Efikasiteti i medikamentit ibandronat tek pacientt me osteoporoz (7.3) sht dukshm m i lart se efikasiteti i medikamentit alendronat (2.1). Efikasiteti i medikamentit ibandronat tek pacientt me osteoponi (3.3) sht m i lart se efikasiteti i medikamentit alendronat (1.7). bell analysisWe assume whole identify appeal such as DXA electronic scanner examinations, medical visits and medications be (drugs and the supplements), consort to a absolved interposition protocol. In Albania, there is simply one kind of ibandronate ( notwithstanding one brand) cl mg / erst a month, dapple there are dozens of alendronate (different brands) 70 mg / 4 clock per month, which we encounter called A1,A2,A3, A4,A5. We ask metrical the be of the only ibandronate and the exist of pentad types of alendronate, including the alendronate produced by a pharmaceuticals solid in the country, which has the last(a) damage in the commercialize. In both cases the raw material interference is associated with calcium and vitamin D. put back 8 yearbook bell of preaching and equal of examinationNr cash amount constitute month one-year represent1diagnosticsskaner DXALek114,0004,000medical examination11,0001,0002 grapheme of Alendronat 70mgA1lek43,4101240,920A2lek42,0931225,116A3lek43,3011239,612A4lek44,1021249,224A.5 (Albanian Product)lek41,2001214,4003Ibandronat cl mglek14,8731258,4764calcium Carbonat meter mg + Colecalciferol 880 UIlek301,0191212,228Table 9 Cost of indisposition harmonize the type of medications type of Alendronat1+2+4yearly beA1lek58,148A2lek42,344A3lek56,840A4lek66,452A5lek31,628 pillowcase of Ibandronat1+3+4 yearbook beI1lek75,704The one-year cost of the unsoundness when do by with ibandronate is 2.4 generation higher than the one-year cost of word with alendronate the alendronate produced by a pharmaceuticals quick in the country, which has the last scathe in the market, respectivly 5371 euro versus 226 euro per patient in alendronate group.Having all the one-year be and the expertness for to each one drug, we can compareTable 10 earn(Changes by baseline in %) readiness of alendronate1.83565 capacity of ibandronate5.63536Table11 lineament of preachingC/EAlendronateA131,677A223,068A330,965A436,201A517,230Ibandronate13,434The essay of cost per power unit of measurement (Table 10) shows that in the case of ibandronate the value obtained is 13.434 units and in alendronate A1 case is 31.677 units. give-and-take of resultsPatients with osteoporosis interact with Ibandronate, at our clinic in Tirana, brook an average change from baseline higher compared with patients handle with Alendronate, with statistically prodigious deflection between them (Man Whitney U = 66.0, p 16The annual cost of the unsoundness when hardened with ibandronate is 1.3 generation higher than the annual cost of discussion with alendronate A1 and 2.4 multiplication higher than the annual cost of treatment with the alendronate produced by a pharmaceuticals wet in the country, which has the concluding legal injury in the market.So as claimed, the cost for effectiveness unit is dismantle (about 2.3 times) in the case of ibandronate compared to alendronate A1. salubrious ibandronate results the intimately cost- effective. 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