Retention, distribution, and effects of intraosseously administered ibandronate in the infarcted femoral head

James Aya-Ay, Sanjay Athavale, Stephanie Morgan-Bagley, Haikuo Bian, Frieder Bauss, Harry K W Kim

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Abstract

The local distribution, retention, and effects of intraosseous administration of ibandronate in the infarcted femoral heads were studied. Intraosseous administration effectively delivered and distributed ibandronate in the infarcted femoral heads and decreased the femoral head deformity in a large animal model of Legg-Calve-Perthes disease. Introduction: Bisphosphonate therapy has gained significant attention for the treatment of ischemic osteonecrosis of the femoral head (IOFH) because of its ability to inhibit osteoclastic bone resorption, which has been shown to contribute to the pathogenesis of femoral head deformity. Because IOFH is a localized condition, there is a need to explore the therapeutic potential of local, intraosseous administration of bisphosphonate to prevent the femoral head deformity. The purpose of this study was to investigate the distribution, retention, and effects of intraosseous administration of ibandronate in the infarcted head. Materials and Methods: IOFH was surgically induced in the right femoral head of 27 piglets. One week later, a second operation was performed to inject 14C-labeled or unlabeled ibandronate directly into the infarcted head. 14C-ibandronate injected heads were assessed after 48 h, 3 weeks, or 7 weeks later to determine the distribution and retention of the drug using autoradiography and liquid scintillation analysis. Femoral heads injected with unlabeled ibandronate were assessed at 7 weeks to determine the degree of deformity using radiography and histomorphometry. Results: Autoradiography showed that 14C-Ibandronate was widely distributed in three of the four heads examined at 48 h after the injection. Liquid scintillation analysis showed that most of the drug was retained in the injected head, and almost negligible amount of radioactivity was present in the bone and organs elsewhere at 48 h. At 3 and 7 weeks, 50% and 30% of the 14C-drug were found to be retained in the infarcted heads, respectively. Radiographic and histomorphometric assessments showed significantly better preservation of the infarcted heads treated with intraosseous administration of ibandronate compared with saline (p < 0.001). Conclusions: This study provides for the first time the evidence that local intraosseous administration is an effective route to deliver and distribute ibandronate in the infarcted femoral head to preserve the femoral head structure after ischemic osteonecrosis. In a localized ischemic condition such as IOFH, local administration of bisphosphonate may be preferable to oral or systemic administration because it minimizes the distribution of the drug to the rest of the skeleton and bypasses the need for having a restored blood flow to the infarcted head for the delivery of the drug.

Original languageEnglish (US)
Pages (from-to)93-100
Number of pages8
JournalJournal of Bone and Mineral Research
Volume22
Issue number1
DOIs
StatePublished - Jan 2007

Fingerprint

Thigh
Head
Osteonecrosis
Diphosphonates
Pharmaceutical Preparations
Autoradiography
ibandronic acid
Legg-Calve-Perthes Disease
Bone Resorption
Skeleton
Radiography
Radioactivity
Therapeutics
Animal Models
Bone and Bones
Injections

Keywords

  • Bisphosphonate
  • Ibandronate
  • Intraosseous
  • Legg-Calve-Perthes disease
  • Osteonecrosis

ASJC Scopus subject areas

  • Surgery

Cite this

Retention, distribution, and effects of intraosseously administered ibandronate in the infarcted femoral head. / Aya-Ay, James; Athavale, Sanjay; Morgan-Bagley, Stephanie; Bian, Haikuo; Bauss, Frieder; Kim, Harry K W.

In: Journal of Bone and Mineral Research, Vol. 22, No. 1, 01.2007, p. 93-100.

Research output: Contribution to journalArticle

Aya-Ay, James ; Athavale, Sanjay ; Morgan-Bagley, Stephanie ; Bian, Haikuo ; Bauss, Frieder ; Kim, Harry K W. / Retention, distribution, and effects of intraosseously administered ibandronate in the infarcted femoral head. In: Journal of Bone and Mineral Research. 2007 ; Vol. 22, No. 1. pp. 93-100.
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