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Original ArticleOpen Access
Observation: Application and Advantages of BMK in Osteoporosis by Monitoring the Dose of Antiresorptive Drugs with CTx
Aksaranugraha S 
One of the potential applications of BMK is the dynamic measure of bone metabolism. The present study aimed to
observe the dynamic response of patients’ bone toward the antiresorptive drugs by using BMK in the prospective procedure.
The subjects were 309 Thai women. They were divided by age into 3 groups: A) 56 participants at 50-60 years old, B) 116
participants at 61-70 years old and C) 137 participants at over 71 years old. They had the blood BMK tests based on these
conditions: 1) prior to the prescription of antiresorptive drugs, 2) every month for following up the administration of the
drugs until the proper doses were obtained, 3) every 3 month after the proper doses were obtained. The patients were
observed on the 5-category criteria resulting in as follows:
Category 1: No previous history of antiresorptive drugs adminitration and the CTx level was lower than normal.
The antiresorptive drugs were not required during this 2-year observation. There were 7 cases aged 50-60, 13 cases aged 61-
70 and 16 cases aged 71 up.
Category 2: No previous history of antiresorptive drugs administration but the CTx was higher than normal. Then
the antiresorptive drugs were prescribed and the CTx later became lower than normal. Thereafter, the antiresorptive drugs
were not required any more through this 2-year study. There were 5 cases aged 50-60, 22 cases aged 61-70 and 22 cases age
d71 up.
Category 3: No previous history of antiresorptive drugs administration but the CTx was higher than normal. The
antiresorptive drugs were prescribed until the CTx became normal or lower than normal, but the values were not stable. So
the drugs were prescribed intermittently. There were 10 cases aged 50-60, 28 cases aged 61-70 and 18 cases aged 71 up.
Category 4: Having the previous history of antiresorptive drugs administration for more than 1 year, and the CTx
was lower than normal. The patients did not take any antiresorptive drugs during this 2-year study. There were 15 cases aged
50-60, 37 cases aged 61-70 and 55 cases aged 71 up.
Category 5: Having the previous history of antiresorptive drugs administration for more than 1 year and the CTx
was lower than normal. Later, the values became higher and the antiresorptive drugs were continued intermittently during the
2-year study. There were 19 cases aged 50-60, 16 cases aged 61-70 and 25 cases aged 71 up.
In conclusion, the change of bone turn over rate after the antiresorptive therapy for individual patients is very
independent and varied. The up and down changes depend on many factors such as environments, genes, etc. Besides, the
time of drugs response evaluated by BMK needed to be assigned within 1 month. The patients’ BMK is suggested to be
observed regularly. The observation is the justifying key not only to determine the suitable amount of antiresorptive drugs as
well as the effective time response on the individual patients but also to help reduce patients’ medical cost.
Keywords: Betacrosslap, CTx, Alendronate, Risedronate, Ibandronate
observe the dynamic response of patients’ bone toward the antiresorptive drugs by using BMK in the prospective procedure.
The subjects were 309 Thai women. They were divided by age into 3 groups: A) 56 participants at 50-60 years old, B) 116
participants at 61-70 years old and C) 137 participants at over 71 years old. They had the blood BMK tests based on these
conditions: 1) prior to the prescription of antiresorptive drugs, 2) every month for following up the administration of the
drugs until the proper doses were obtained, 3) every 3 month after the proper doses were obtained. The patients were
observed on the 5-category criteria resulting in as follows:
Category 1: No previous history of antiresorptive drugs adminitration and the CTx level was lower than normal.
The antiresorptive drugs were not required during this 2-year observation. There were 7 cases aged 50-60, 13 cases aged 61-
70 and 16 cases aged 71 up.
Category 2: No previous history of antiresorptive drugs administration but the CTx was higher than normal. Then
the antiresorptive drugs were prescribed and the CTx later became lower than normal. Thereafter, the antiresorptive drugs
were not required any more through this 2-year study. There were 5 cases aged 50-60, 22 cases aged 61-70 and 22 cases age
d71 up.
Category 3: No previous history of antiresorptive drugs administration but the CTx was higher than normal. The
antiresorptive drugs were prescribed until the CTx became normal or lower than normal, but the values were not stable. So
the drugs were prescribed intermittently. There were 10 cases aged 50-60, 28 cases aged 61-70 and 18 cases aged 71 up.
Category 4: Having the previous history of antiresorptive drugs administration for more than 1 year, and the CTx
was lower than normal. The patients did not take any antiresorptive drugs during this 2-year study. There were 15 cases aged
50-60, 37 cases aged 61-70 and 55 cases aged 71 up.
Category 5: Having the previous history of antiresorptive drugs administration for more than 1 year and the CTx
was lower than normal. Later, the values became higher and the antiresorptive drugs were continued intermittently during the
2-year study. There were 19 cases aged 50-60, 16 cases aged 61-70 and 25 cases aged 71 up.
In conclusion, the change of bone turn over rate after the antiresorptive therapy for individual patients is very
independent and varied. The up and down changes depend on many factors such as environments, genes, etc. Besides, the
time of drugs response evaluated by BMK needed to be assigned within 1 month. The patients’ BMK is suggested to be
observed regularly. The observation is the justifying key not only to determine the suitable amount of antiresorptive drugs as
well as the effective time response on the individual patients but also to help reduce patients’ medical cost.
Keywords: Betacrosslap, CTx, Alendronate, Risedronate, Ibandronate
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