The role of zoledronic acid in the management of osteoporosis
- 11 June 2010
- journal article
- review article
- Published by Springer Science and Business Media LLC in Clinical Rheumatology
- Vol. 29 (10), 1079-1084
- https://doi.org/10.1007/s10067-010-1486-3
Abstract
Bisphosphonates are the current standard of care for treatment of osteoporosis. However, oral bisphosphonates are associated with complicated dosing regimens because of poor absorption and have the potential for upper gastrointestinal (GI) tract irritation, resulting in poor adherence and persistence. Zoledronic acid (ZOL) 5 mg, a once-yearly intravenous bisphosphonate, is approved for treatment and prevention of postmenopausal osteoporosis, increasing bone mass in men with osteoporosis, and treatment and prevention of glucocorticoid-induced osteoporosis. Because it is administered as an infusion, ZOL ensures adherence and persistence over the entire 12-month dosing interval and bypasses the GI absorption/irritation problems associated with oral bisphosphonates. The objective of this study was to review the safety and efficacy of 5 mg ZOL and its potential for improving patient compliance. Published reports dating back to 2001 were reviewed, with emphasis on osteoporosis treatment. In the HORIZON-Pivotal Fracture Trial, annual infusions of 5 mg ZOL produced significant reductions in risk of morphometric vertebral fractures (70%) and hip fractures (41%) vs placebo over 3 years in postmenopausal women with osteoporosis. In the HORIZON-Recurrent Fracture Trial, an annual infusion of 5 mg ZOL after repair of a recent low-trauma hip fracture was associated with significant reductions in risk for new clinical fractures (35%) vs placebo. In men with osteoporosis, an annual treatment of ZOL over 2 years increased lumbar spine bone mineral density (BMD) by 6% compared with baseline. In patients starting or continuing treatment with chronic glucocorticoids, ZOL resulted in significantly greater increases in lumbar spine BMD over 1 year than an oral bisphosphonate. In postmenopausal women with osteopenia, a single infusion of ZOL over a 2-year period produced significantly greater gains in lumbar spine and hip BMD than placebo. ZOL is generally safe and well tolerated. Five milligrams of ZOL has the potential to improve compliance with osteoporosis therapy and, consequently, to reduce fracture risk in clinical practice.Keywords
This publication has 17 references indexed in Scilit:
- Zoledronic Acid and Clinical Fractures and Mortality after Hip FractureNew England Journal of Medicine, 2007
- Bisphosphonate-Associated Osteonecrosis of the Jaw: Report of a Task Force of the American Society for Bone and Mineral ResearchJournal of Bone and Mineral Research, 2007
- Intravenous zoledronic acid 5 mg in the treatment of postmenopausal women with low bone density previously treated with alendronateBone, 2007
- Once-Yearly Zoledronic Acid for Treatment of Postmenopausal OsteoporosisNew England Journal of Medicine, 2007
- Patient Adherence to Osteoporosis MedicationsDrugs & Aging, 2007
- Adherence to Bisphosphonate Therapy and Fracture Rates in Osteoporotic Women: Relationship to Vertebral and Nonvertebral Fractures From 2 US Claims DatabasesMayo Clinic Proceedings, 2006
- Adherence to MedicationNew England Journal of Medicine, 2005
- Early discontinuation of treatment for osteoporosisAmerican Journal Of Medicine, 2003
- Pharmacologic profile of zoledronic acid: A highly potent inhibitor of bone resorptionDrug Development Research, 2002
- Intravenous Zoledronic Acid in Postmenopausal Women with Low Bone Mineral DensityNew England Journal of Medicine, 2002