J Bone Metab.  2025 Feb;32(1):21-30. 10.11005/jbm.24.787.

Pharmacogenetics of Response to Bisphosphonate Treatment in Postmenopausal Osteoporosis: A Prospective Study

Affiliations
  • 1Department of Physical Medicine and Rehabilitation, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Türkiye
  • 2Department of Physical Medicine and Rehabilitation, Koç University School of Medicine, İstanbul, Türkiye
  • 3Department of Physical Medicine and Rehabilitation, Muğla Training and Research Hospital, Muğla, Türkiye
  • 4Department of Medical Biochemistry, Gazi University Faculty of Medicine, Ankara, Türkiye
  • 5Department of Physical Medicine and Rehabilitation, Gazi University Faculty of Medicine, Ankara, Türkiye

Abstract

Background
This study aims to investigate the effect of genetic polymorphisms of vitamin D receptor (VDR), estrogen receptor 1 (ER1), and Col1a1 on the response to bisphosphonate (BP) therapy in women with postmenopausal osteoporosis (OP).
Methods
Twenty-one women with postmenopausal OP who received alendronate, ibandronate, or zoledronic acid for one year were enrolled in this study. Bone mineral density (BMD) at the lumbar spine and femoral neck were assessed by dual energy X-ray absorptiometry at baseline and after 12 months. Serum osteocalcin levels were measured at baseline and after 12 months. Polymorphic sites of the genes encoding ER1, VDR and Col1a1 proteins were amplified by polymerase chain reaction and examined using restriction fragment length polymorphism. Response to BP treatment and change in osteocalcin levels were compared among women with different gene polymorphisms.
Results
Ratio of responders to treatment regarding improvements in the BMD of lumbar spine and femoral neck was adequate in 76% and 62%, respectively. There was no significant difference in treatment response regarding BMD in either region or change in serum osteocalcin levels among different gene polymorphisms.
Conclusions
These findings did not support the potential role of VDR BsmI, Col1a1 Sp1, ER1 PvuII, or XbaI polymorphisms in predicting the response to BP therapy in women with postmenopausal OP. Further investigation with larger prospective studies is required.

Keyword

Diphosphonates · Osteoporosis · Pharmacogenetics · Polymorphism, genetic · Vitamin D
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