Sharifeh Khatib
1 
, Sara Roomizadeh
1 , Ladan Dayani
2 , Awat Feizi
3 , Saba Shahparyan
1* , Sayed Abolfazl Mostafavi
2* 1 Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of Pharmaceutics, Isfahan Pharmaceutical Science Research Center, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
3 Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Introduction: Osteoporosis is characterized by reduced bone mineral density and an increased risk of fractures, resulting in substantial healthcare costs and higher mortality. Bisphosphonates, such as alendronate, effectively treat osteoporosis by inhibiting bone resorption; however, their limited oral bioavailability restricts therapeutic efficacy. This study aims to evaluate different strategies developed to enhance the oral bioavailability of alendronate.
Methods: A comprehensive literature search was performed across multiple databases without language or publication date restrictions, using a predefined search strategy. Two independent reviewers screened and selected eligible studies according to predetermined inclusion and exclusion criteria. The inclusion criteria comprised in vivo animal studies investigating the pharmacokinetics of alendronate formulations, focusing on bioavailability. Studies lacking essential pharmacokinetic data were excluded. Extracted data included pharmacokinetic parameters such as Cmax, Tmax, AUC₀–t, AUC₀–∞, and bioavailability, along with study characteristics, drug properties, animal details, and formulation specifics. Discrepancies in data extraction were resolved through discussion and consensus between reviewers.
Results: Meta-analyses revealed significant differences in AUC₀–∞ and bioavailability between novel drug delivery systems (NDDS) and the pure drug (P < 0.05), while no significant differences were observed in Cmax and Tmax (P > 0.05).
Conclusion: The drug delivery systems evaluated in this review demonstrated a marked influence on pharmacokinetic parameters and enhancement of bioavailability. These findings suggest that the use of NDDS may improve the bioavailability and therapeutic effectiveness of alendronate.