The effect of intravenous zoledronic acid on glucocorticoid-induced multiple vertebral fractures in juvenile systemic lupus erythematosus

Glucocorticoids are widely used in the treatment of lupus patients, and adverse effects, which include osteoporosis and associated fractures, are frequent. Treatment of osteoporosis of young patients should be effective and not harmful to bone growth and remodeling. Bisphosphonates are drugs that decrease the incidence of bone fractures, but their use in juvenile patients is still controversial because of their possible side effects on the growing skeleton. However, recently published studies showed that linear growth continued normally after treatment with these drugs, and there was no excessive suppression of bone remodeling or mineralization defects. Zoledronic acid is a new intravenous bisphosphonate that has been approved by the US FDA for use with hypercalcemia of malignancies and might be an effective treatment for postmenopausal osteoporosis. The authors report a case of a young girl with systemic lupus who developed multiple vertebral collapses due to glucocorticoid therapy, and zoledronic acid was used producing significant clinical and densitometric improvement.

Bifosfonatos (BFs) como transportadores osteotrópicos no planejamento de fármacos dirigidos

Drug therapy involving bone tissue diseases is difficult, calling for the design of specific drugs. The present paper is a brief review of a new site-directed system termed ODDS (osteotropic drug delivery system), based on a latenciation process, using bisphosphonates as bone carriers. This is an important tool for the rational prodrug design for obtaining selective drugs.

Bisfosfonatos: síntese, análises químicas e aplicações farmacológicas

Bisphosphonates are drugs that have been widely used in different bone diseases, and have recently been used successfully against many parasites. Various synthetic routes to prepare different types of bisphosphonates have been described, with distinct potency and pharmacological activity. A number of analytical techniques are currently being used to analyze these drugs; among these, the high performance liquid chromatography (HPLC), with different systems of detection, is worth highlighting. However, the development of more sensitive methods is still necessary, once they are essential for bioavailability and bioequivalence studies. This paper reports the major synthesis routes, chemical analysis methodologies and pharmacological applications of bisphosphonates.