関: clodronic acid、sodium clodronate hydrate

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/10/24 09:09:01」(JST)

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Clodronic acid (INN) or clodronate disodium (USAN) is a first generation (non-nitrogenous) bisphosphonate. It is an anti-osteoporotic drug approved for the prevention and treatment of osteoporosis in post-menopausal women and men to reduce vertebral fractures, hyperparathyroidism, hypercalcemia in malignancy, multiple myeloma and fracture related pain because of its potent anti-inflammatory and analgesic effects shown as a reduction in inflammatory markers like IL-1β, IL-6, and TNF-α.^[1] While bisphosphonates are shown to be effective in reducing vertebral fractures and pain, their role in improving overall survival remains unclear.^[2]

An Italian study compared the analgesic effect of clodronic acid versus acetaminophen in rheumatic condition related pain. Study result show a reduction in pain in favor of clodronic acid that provided more analgesia than 3 grams/day of acetaminophen. Clodronic acid is also used in experimental medicine to selectively deplete macrophages.

Clodronic acid is approved for human use in Canada and Australia, the United Kingdom, where it is marketed as Bonefos, Loron, Clodron and in Italy as Clasteon, Difosfonal, Osteostab and several generics. In other countries is prescribed as a bone resorption inhibitor and antihypercalcemic agent. It is not approved for use in the United States, because it has too many adverse effects.

Use in equine medicine

Clodronic acid is approved for use in horses under the trade name Osphos, for treatment of bone resorptive processes of navicular syndrome. It is given by intramuscular injection at one point in time, with the total dose divided into 2-3 sites on the horse. Clinical effects (e.g. improvement of lameness) after a single treatment can be seen up to 6 months post-treatment.

Adverse reactions and contraindications

Clodronic acid has been shown to have several adverse effects. These include:^[3]

Signs of discomfort, agitation, or colic, usually within 2 hours of treatment.
Head shaking
Lip licking

References

^ Pennanen, Niina; Lapinjoki, Seppo; Urtti, Arto; Mönkkönen, Jukka (1995). "Effect of Liposomal and Free Bisphosphonates on the IL-1β, IL-6 and TNFα Secretion from RAW 264 Cells in Vitro". Pharmaceutical Research. 12 (6): 916–922. ISSN 0724-8741. doi:10.1023/A:1016281608773.
^ Mhaskar, Rahul; Redzepovic, Jasmina; Wheatley, Keith; Clark, Otavio Augusto Camara; Miladinovic, Branko; Glasmacher, Axel; Kumar, Ambuj; Djulbegovic, Benjamin; Kumar, Ambuj (2012). "Bisphosphonates in multiple myeloma: a network meta-analysis". Cochrane Database of Systematic Reviews. 5: CD003188. PMID 22592688. doi:10.1002/14651858.CD003188.pub3.
^ U.S. Food and Drug Administration. "FDA Provides Equine Veterinarians with Important Information about TILDREN and OSPHOS for Navicular Syndrome in Horses". Retrieved 3 January 2015.

UpToDate Contents

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1. 高カルシウム血症の治療 treatment of hypercalcemia
2. ステロイド誘発性骨粗鬆症の予防および治療 prevention and treatment of glucocorticoid induced osteoporosis
3. 乳癌からの骨転移マネージメントにおける破骨細胞阻害 osteoclast inhibition in the management of bone metastases from breast cancer
4. 多発性骨髄腫患者のビスフォスフォネート製剤の使用 the use of bisphosphonates in patients with multiple myeloma
5. 進行性前立腺癌における骨転移のマネージメント management of bone metastases in advanced prostate cancer

English Journal

Macrophage infiltration predicts a poor prognosis for human ewing sarcoma.

Fujiwara T, Fukushi J, Yamamoto S, Matsumoto Y, Setsu N, Oda Y, Yamada H, Okada S, Watari K, Ono M, Kuwano M, Kamura S, Iida K, Okada Y, Koga M, Iwamoto Y.SourceDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
The American journal of pathology.Am J Pathol.2011 Sep;179(3):1157-70. Epub 2011 Jul 21.
Ewing sarcoma-primitive neuroectodermal tumor (EWS) is associated with the most unfavorable prognosis of all primary musculoskeletal tumors. The objective of the present study was to investigate whether tumor-associated macrophages (TAMs) affect the development of EWS. TAMs were isolated from mouse
PMID 21771572

Cytotoxic effect of clodronate and zoledronate on the chondrosarcoma cell lines HTB-94 and CAL-78.

Streitbuerger A, Henrichs M, Ahrens H, Lanvers-Kaminzky C, Gouin F, Gosheger G, Hardes J.SourceDepartment of Orthopedics, University Hospital of Munster, Munster, Germany, streitb@ukmuenster.de.
International orthopaedics.Int Orthop.2011 Sep;35(9):1369-73. Epub 2010 Oct 2.
The wide surgical tumour resection is the only effective treatment in chondrosarcoma. However, a major problem remains the high rate of local recurrences and metastases due to the lack of adjuvant therapies. In this study the cytotoxic effect of the bisphosphonate clodronate (0.1-1000?μM) and zole
PMID 20890703

Japanese Journal

Bisphosphonates による炎症性副作用の機序・予防・治療

船山ひろみ
小児歯科学雑誌 48(4), 495-504, 2010-09-25
NAID 10027490234

OP-074 マウス腎 : 側尿管閉塞(UUO)モデルにおけるliposome clodronateの腎内白血球浸潤および腎線維化に対する効果の検討(上部尿路・腎不全,一般演題口演,第98回日本泌尿器科学会総会)

北本興市郎,町田裕一,内田潤次,仲谷達也,三浦克之
日本泌尿器科學會雜誌 101(2), 251, 2010-02-20
NAID 110007867992

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★リンクテーブル★

リンク元	「クロドロン酸」「clodronic acid」「クロドロネート」
拡張検索	「sodium clodronate hydrate」

「クロドロン酸」

Clodronic acid
Clinical data
AHFS/Drugs.com	International Drug Names
ATC code	M05BA02 (WHO);
Identifiers
	IUPAC name (Dichloro-phosphono-methyl)phosphonic acid;
CAS Number	10596-23-3 ;
PubChem CID	25419;
DrugBank	DB00720 ;
ChemSpider	23731 ;
UNII	0813BZ6866;
KEGG	D03545 ;
ChEBI	CHEBI:110423 ;
ChEMBL	CHEMBL12318 ;
ECHA InfoCard	100.031.090
Chemical and physical data
Formula	CH4Cl2O6P2
Molar mass	244.892 g/mol
3D model (JSmol)	Interactive image;
	SMILES ClC(Cl)(P(=O)(O)O)P(=O)(O)O ;
	InChI InChI=1S/CH4Cl2O6P2/c2-1(3,10(4,5)6)11(7,8)9/h(H2,4,5,6)(H2,7,8,9) ; Key:ACSIXWWBWUQEHA-UHFFFAOYSA-N ;
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　　[★]

英: clodronate、clodronic acid、sodium clodronate hydrate
関: クロドロネート、クロドロン酸ナトリウム水和物

「clodronic acid」

　　[★]

クロドロン酸

関: clodronate、sodium clodronate hydrate

「クロドロネート」

　　[★]

英: clodronate
関: クロドロン酸

「sodium clodronate hydrate」

　　[★]

クロドロン酸ナトリウム水和物

関: clodronate、clodronic acid

[1] Pennanen, Niina; Lapinjoki, Seppo; Urtti, Arto; Mönkkönen, Jukka (1995). "Effect of Liposomal and Free Bisphosphonates on the IL-1β, IL-6 and TNFα Secretion from RAW 264 Cells in Vitro". Pharmaceutical Research. 12 (6): 916–922. ISSN 0724-8741. doi:10.1023/A:1016281608773.

[2] Mhaskar, Rahul; Redzepovic, Jasmina; Wheatley, Keith; Clark, Otavio Augusto Camara; Miladinovic, Branko; Glasmacher, Axel; Kumar, Ambuj; Djulbegovic, Benjamin; Kumar, Ambuj (2012). "Bisphosphonates in multiple myeloma: a network meta-analysis". Cochrane Database of Systematic Reviews. 5: CD003188. PMID 22592688. doi:10.1002/14651858.CD003188.pub3.

[3] U.S. Food and Drug Administration. "FDA Provides Equine Veterinarians with Important Information about TILDREN and OSPHOS for Navicular Syndrome in Horses". Retrieved 3 January 2015.

v t e Drugs for treatment of bone diseases (M05)
Bisphosphonates	Nitrogenous (Alendronic acid ibandronic acid incadronic acid pamidronic acid risedronic acid zoledronic acid) Non-nitrogenous (Etidronic acid clodronic acid tiludronic acid)
Bone morphogenetic proteins	Dibotermin alfa Eptotermin alfa
Other	Resorption inhibitor (Ipriflavone) Aluminium chlorohydrate Dual action bone agent (Strontium ranelate) RANKL inhibitor (Denosumab) Cathepsin K inhibitor (Odanacatib) Calcium Vitamin D

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clodronate