Published online Aug 11, 2016.
https://doi.org/10.4055/jkoa.2016.51.4.320
A Interventional Study in a Real Life Setting to Assess the Clinical Efficacy and Effect on Fracture in the 1 Year after Injection of Zoledronic Acid in Osteoporotic Patients with Long Bone or Spine, Pelvic Fractures
Abstract
Purpose
We studied the improvement of back pain in vertebral fracture and fracture healing in non-vertebral fracture after treatment with zoledronate in postmenopausal patients.
Materials and Methods
Postmenopausal women with bone mineral density (BMD) T-score of -2.5 or less and existing vertebral fractures or non-vertebral fractures between January 2011 and June 2012 were included. Patients received a single intravenous infusion of zoledronate within 3 days after diagnosis of fractures. The primary outcome was BMD and secondary outcomes were visual analogue scale (VAS) for back pain, fracture healing, and new clinical fracture.
Results
T-score increased significantly in the vertebral fracture group (n=97) and non-vertebral fracture group (n=31) at 1 year (p<0.05). The average VAS for back pain decreased significantly in the vertebral fracture group (p<0.05) and there was no delayed union, nonunion in the non-vertebral fracture group. There was no re-fracture and 3 new clinical fractures (2.34%) occurred during the follow-up period.
Conclusion
Zoledronate, as treatment in postmenopausal osteoporosis patients can improve BMD, reduce back pain in vertebral fracture, and has no negative effect on bone healing after fracture in non-vertebral fracture.
Figure 1
Patient enrollment.
Figure 2
Change of back pain (VAS) in patients with vertebral fracture. VAS, visual analogue scale.
Table 1
Change of BMD
Table 2
Change of Back Pain (VAS) in Vertebral Fracture Group Who Didn't Have Vertebroplasty (n=71)
Table 3
Adverse Events in Zoledronate Treated Patients (n=253)
This study is supported with research funding from the Novartis.
CONFLICTS OF INTEREST:The authors have nothing to disclose.
References
-
Lee JH, Lee J, Seo WS, Park YS. Analysis of adherence of once-yearly intravenous zolendronic acid for osteoporosis. Osteoporosis 2014;12:22–29.
-
-
Colón-Emeric C, Nordsletten L, Olson S, et al. HORIZON Recurrent Fracture Trial. Association between timing of zoledronic acid infusion and hip fracture healing. Osteoporos Int 2011;22:2329–2336.
-
-
Manicourt DH, Altman RD, Williams JM, et al. Treatment with calcitonin suppresses the responses of bone, cartilage, and synovium in the early stages of canine experimental osteoarthritis and significantly reduces the severity of the cartilage lesions. Arthritis Rheum 1999;42:1159–1167.
-
-
Van Offel JF, Schuerwegh AJ, Bridts CH, Bracke PG, Stevens WJ, De Clerck LS. Influence of cyclic intravenous pamidronate on proinflammatory monocytic cytokine profiles and bone density in rheumatoid arthritis treated with low dose prednisolone and methotrexate. Clin Exp Rheumatol 2001;19:13–20.
-
-
Varenna M, Zucchi F, Ghiringhelli D, et al. Intravenous clodronate in the treatment of reflex sympathetic dystrophy syndrome. A randomized, double blind, placebo controlled study. J Rheumatol 2000;27:1477–1483.
-
-
Lee SH, Na WC, Park YK. Effect of intravenous administration of bisphosphonate for patients operatively treated for osteoporotic hip fracture. Hip Pelvis 2012;24:133–138.
-