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KMID : 1024720190090010019
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Geriatric Rehabilitation
2019 Volume.9 No. 1 p.19 ~ p.27
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Effectiveness of Intravenous or Oral Bisphosphonates in Stroke Patients with Osteoporosis
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Yoo Myung-Chul
Kim Dong-Hwan
Lee Seung-Ah
Han Young-Rok
Yoo Seung-Don
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Abstract
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Objective: Hemiplegic stroke and subsequent immobility predispose patients to bone loss, resulting in a rapid reduction in bone mineral density (BMD). Treatment with bisphosphonates is one of the major pharmacological treatments for osteoporosis. However, in stroke patients, the use of oral bisphosphonates is limited by issues such as dysphagia, low compliance and persistence. This study aimed to evaluate the effectiveness of oral or intravenous bisphosphonates in a clinical setting of stroke patients.
Methods: All medical records were retrospectively obtained from patients who were admitted to our university hospital. Of 63 hemiplegic stroke patients with osteoporosis treated with bisphosphonates, 23 received oral alendronate 70 mg/week, 20 received oral risedronate 35 mg/week, and 20 received intravenous zoledronate 5 mg/100 mL once annually. The BMD and T-scores were measured at baseline and 1 year after starting treatment.
Results: There were significant increases compared with baseline values in the BMD and T-scores at the lumbar spine at 1 year with all 3 bisphosphonates, whereas the mean femoral neck, trochanter, and total body BMD and T-scores were not significantly increased in all 3 bisphosphonates groups. In addition, the route of administration of oral and intravenous
bisphosphonates was compared, and no differences were observed in terms of the effectiveness of oral versus intravenous bisphosphonates.
Conclusion: Treatment with oral or intravenous bisphosphonates is effective in preserving BMD and T-scores after stroke patients with osteoporosis. Yearly intravenous injection of bisphosphonates may be a good treatment option for stroke patients with osteoporosis who have difficulty taking oral medications.
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KEYWORD
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Bone mineral density (BMD), Bisphosphonates, Osteoporosis, Stroke
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