Etidronate is an oral
bisphosphonate compound that is known to reduce
bone resorption through the inhibition of osteoclastic activity. The efficacy of
etidronate for involutional (postmenopausal and senile) and
glucocorticoid-induced
osteoporosis, as well as that for other skeletal diseases, was reviewed in Japanese patients. Cyclical
etidronate treatment (200 mg or 400mg/day for 2 weeks about every 3 months) increases the lumbar bone mineral density (BMD) in patients with involutional
osteoporosis and prevents incident vertebral fractures in patients with
glucocorticoid-induced
osteoporosis. The losses of the lumbar BMD in patients with
liver cirrhosis and the metacarpal BMD in hemiplegic patients after
stroke are prevented, and the lumbar BMD is possibly increased, preventing fragile fractures in adult patients with
osteogenesis imperfecta type I. Furthermore, proximal
bone resorption around the femoral stem is reduced and some complications may be prevented in patients who undergo cementless
total hip arthroplasty. Oral
etidronate treatment may also help to transiently relieve metastatic
cancer bone
pain followed by a decrease in abnormally raised
bone resorption in patients with painful bone
metastases from primary
cancer sites, such as the lung, breast and prostate. Thus, oral
etidronate treatment is suggested to be efficacious for
osteoporosis, as well as other skeletal diseases associated with increased
bone resorption, in Japanese patients. Randomized controlled trials needed to be conducted on a large number of patients to confirm these effects.