scholarly journals SUN-386 Treatment Outcomes of Intravenous Zoledronic Acid vs Oral Alendronate in Postmenopausal Women with Osteoporosis

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Zar Chi Pyone ◽  
Moe Wint Aung ◽  
Thein Myint ◽  
Than Saw Khin ◽  
Thinn Thinn Hlaing
Keyword(s):  
Zoledronic Acid ◽  
Adverse Effects ◽  
Treatment Outcomes ◽  
Postmenopausal Women ◽  
Postmenopausal Osteoporosis ◽  
Phase Reaction ◽  
Mineral Density ◽  
Acid Infusion ◽  
Oral Bisphosphonate ◽  
One Year

Abstract In real practice, many patients with osteoporosis are poorly compliant with oral bisphosphonate, partly due to gastrointestinal side effects and partly due to medication procedure leading to premature termination of treatment. Once yearly intravenous zoledronic acid is well tolerated; little or no gastrointestinal effects and effective drug in treatment of postmenopausal osteoporosis with favourable dosing regimen to improve compliance of patients. So this study aims to study treatment outcomes of intravenous zoledronic acid vs oral alendronate in postmenopausal women with osteoporosis. This study was a randomized open label comparative study and included 94 postmenopausal women with osteoporosis. In this study, once yearly zoledronic acid (ZOL) infusion provided a greater reduction of serum procollagen type 1 N propeptide (P1NP) at 3 months than once weekly oral alendronate (ALN). Percentages of P1NP change in ZOL group was -70.25±17.51% and ALN group was -60.61±18.87% (P= 0.012). A decrease of P1NP ≥40% was observed in the majority of patients in both groups (89.4% in ZOL group and 85.1% in ALN group) (P= 0.536). ZOL was non-inferior to ALN in terms of BMD change at lumbar spine (4.8±5.5% in ZOL versus 4.9±4.5% in ALN treated patients) with P value of 0.922 and also at total hip (3.8±8.0% in ZOL versus 3.8±7.5% in ALN group) (P= 0.970). Two cases (4.3%) of new fractures was observed in ZOL group whereas 4 cases (8.5%) of new fractures occurred in ALN group over one year of study. The overall frequencies of treatment related adverse effects were similar between ZOL group (57.4%) and ALN group (42.6%) (P= 0.149). ZOL group showed significantly increased frequencies of musculoskeletal pain (57.4%) and acute phase reaction (12.8%) and 12.8% of participants in ALN group complained of heartburn. The overall preference to continue current medication was higher in ZOL group than ALN group (P= 0.002). The participants treated with ZOL were tend to have more satisfaction (P= 0.026) and willing to receive it longer period (P< 0.001).Compared to weekly oral alendronate therapy in treatment of postmenopausal osteoporosis, yearly infusion of 5 mg zoledronic acid infusion produced a significant greater response in serum P1NP at 3 months and similar change in BMD at one year of treatment and overall frequencies of adverse effects were similar between two treatment groups with excellent patient preference and satisfaction after zoledronate treatment. Reference: (1) Al-Bogami et al (2015) Favorable therapeutic response of osteoporotic patients to treatment with intravenous zoledronate compared with oral alendronate. Saudi Med J. 36(11):1305-1311. (2) Saag et al (2007) A single zoledronic acid infusion reduces bone resorption markers more rapidly than weekly oral alendronate in postmenopausal women with low bone mineral density. Bone. 40:1238-1243.

ACUTE PHASE REACTIONS AFTER ZOLEDRONIC ACID INFUSION: PROTECTIVE ROLE OF 25-HYDROXYVITAMIN D AND PREVIOUS ORAL BISPHOSPHONATE THERAPY

2018 ◽  
Vol 24 (5) ◽  
pp. 405-410 ◽  
Author(s):  
Chiara Crotti ◽  
Nelson B. Watts ◽  
Maria De Santis ◽  
Angela Ceribelli ◽  
Gianluigi Fabbriciani ◽  
...  
Keyword(s):  
Zoledronic Acid ◽  
Acute Phase ◽  
Protective Role ◽  
Bisphosphonate Therapy ◽  
Acid Infusion ◽  
Hydroxyvitamin D ◽  
Oral Bisphosphonate ◽  
25 Hydroxyvitamin D ◽  
Acute Phase Reactions

scholarly journals Serumβ-Catenin Levels Associated with the Ratio of RANKL/OPG in Patients with Postmenopausal Osteoporosis

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Xiao-Juan Xu ◽  
Lin Shen ◽  
Yan-Ping Yang ◽  
Rui Zhu ◽  
Bo Shuai ◽  
...  
Keyword(s):  
Bone Turnover ◽  
Postmenopausal Women ◽  
Postmenopausal Osteoporosis ◽  
Bone Turnover Markers ◽  
Enzyme Linked Immunosorbent Assay ◽  
Functional Communication ◽  
Mineral Density ◽  
Wnt Pathways ◽  
Turnover Markers

Objective. To demonstrate the role of Wnt/β-catenin canonical pathway in postmenopausal osteoporosis by evaluating serumβ-catenin levels in patients with postmenopausal osteoporosis and analyzing their possible relationship with serum OPG, RANKL, the ratio of RANKL/OPG, sclerostin, and bone turnover markers.Methods. 480 patients with postmenopausal osteoporosis and 170 healthy postmenopausal women were enrolled in the study. Serumβ-catenin, OPG, RANKL, and sclerostin levels were measured by enzyme-linked immunosorbent assay. Bone status was assessed by measuring bone mineral density and bone turnover markers. Estradiol levels were also detected.Results. Serumβ-catenin levels were lower in postmenopausal osteoporotic women compared to nonosteoporotic postmenopausal women (26.26±14.81versus39.33±5.47 pg/mL,P<0.001). Serumβ-catenin was positively correlated with osteoprotegerin (r=0.232,P<0.001) and negatively correlated with the ratio of RANKL/OPG, body mass index, and sclerostin (r=-0.128,P=0.005;r=-0.117,P=0.010;r=-0.400,P<0.001, resp.) in patients with postmenopausal osteoporosis.Conclusion. The results indicate that lower serumβ-catenin and concomitantly higher ratio of RANKL/OPG may be involved in the pathogenesis of postmenopausal osteoporosis. Functional communication between RANKL/RANK/OPG system and Wnt pathways plays an important role in postmenopausal osteoporosis.

Association Between Serum Ferritin Levels and Low Bone Mineral Density in Postmenopausal Osteoporosis Women

2020 ◽  
Author(s):  
Lama ALjeshi ◽  
Shaden Haddad
Keyword(s):  
Bone Mineral Density ◽  
Postmenopausal Women ◽  
Postmenopausal Osteoporosis ◽  
Bone Mineral ◽  
Serum Ferritin ◽  
Serum Ferritin Level ◽  
Ferritin Level ◽  
Mineral Density ◽  
Low Bone Mineral Density ◽  
Femur Neck

As women go through menopause, serum estrogen decreases, and ferritin increases. Ferritin is an essential component of the body, but many studies have stated that ferritin, which exceeds the normal physiological range, may potentially cause health problems in women. The aim of this study is to investigate the relationship between bone mineral density and serum ferritin levels in post-menopausal women and to evaluate serum ferritin levels as a potential biomarker for postmenopausal osteoporosis. Serum ferritin levels were measured in 62 postmenopausal women with low bone mineral density, and in 18 postmenopausal healthy control women using a standardized Enzyme-Linked Immune Sorbent Assay (ELISA) kit. Bone mineral density BMD was assessed at the lumbar spine and femoral neck. The mean serum ferritin level was significantly higher in the postmenopausal women with low BMD group (group 1) than in the normal control group (group 2), respectively (mean=262.69 vs. 181.44 ng/ml, (P<0.05), and serum ferritin level was negatively correlated with BMD among low BMD postmenopausal women's group (R= -0.628, P=0.0001), and in the healthy postmenopausal group (R= -0.052, P=0.838). A comparison of the BMD between spine and femur neck sites shows that the frequency of low BMD in the spine site is higher than the femur neck site. Our findings show that increased serum ferritin levels were associated with low bone mineral density in postmenopausal osteoporosis.

Evaluation of the protective effects of zoledronic acid on bone mass in premenopausal women undergoing adjuvant chemotherapy following treatment discontinuation

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 562-562
Author(s):  
D. L. Hershman ◽  
D. McMahon ◽  
K. D. Crew ◽  
T. Shao ◽  
S. Cremers ◽  
...  
Keyword(s):  
Zoledronic Acid ◽  
Adjuvant Chemotherapy ◽  
Bone Loss ◽  
Premenopausal Women ◽  
Phase Iii ◽  
Secondary Outcome ◽  
First Year ◽  
Mineral Density ◽  
Double Blind ◽  
One Year

562 Background: Adjuvant chemotherapy is associated with a significant reduction in bone mineral density (BMD) in premenopausal women with breast cancer (BC). We previously showed that this loss of BMD can be prevented with zoledronic acid (ZA) every 3 months for a year. Since bone loss in women with osteoporosis is prevented with annual ZA, we examined whether protection from bone loss by ZA in women with BC persists following discontinuation of ZA. Methods: A randomized, double-blind, multicenter, phase III trial comparing ZA (4 mg every 3 months) versus placebo for 1 year in premenopausal women with BC undergoing adjuvant chemotherapy was conducted. Patients had serial BMD measurement at 0 (after surgery and before chemotherapy), 6, 12 and 24 months. Demographic, clinical, and tumor characteristics were collected. Serum was stored at -70°C and analyzed in batches. The secondary outcome of percent change in BMD at 24 months, one year following the last ZA/placebo, is presented. Intention-to-treat analyses with linear mixed models were performed using SAS version 9. Results: Of 101 patients randomized, 85 completed 12 month, and 62 completed 24 month evaluations; mean age 41 (SD 5.2). Demographic and baseline characteristics were similar between treatment groups. By 24 months, 38 (61%) had not regained their menses; 22 patients were on tamoxifen, 25 were on an aromatase inhibitor. Chemotherapy without ZA was associated with a significant decline from baseline in lumbar spine (LS) BMD after both 12 (-5.4%) and 24 (-6.3%) months. Similarly total hip (TH) and femoral neck (FN) BMD declined by 2.6% and 2.4% by 24 months, respectively. In contrast, BMD remained stable in ZA-treated patients (p < 0.0001 vs placebo). Patients who received ZA had stable BMD at 24 months (LS -0.58%, TH 0.83%, FN 0.04%). Analysis of bone turnover markers is ongoing. Conclusions: Premenopausal women receiving adjuvant chemotherapy for BC had significant bone loss in the first year that persisted in the second year. ZA every 3 months for a year effectively prevented bone loss during the first year and 1 year after completion of ZA treatment. One year of ZA maintains BMD in premenopausal BC patients for an additional year after discontinuation of ZA. [Table: see text]

Zoledronic acid for the prevention of bone loss in patients with previously untreated lymphoma undergoing chemotherapy

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20611-e20611
Author(s):  
V. D. Cataldo ◽  
M. A. Thompson ◽  
B. B. Toth ◽  
P. Sanjorjo ◽  
S. J. Bourgeois ◽  
...  
Keyword(s):  
Vitamin D ◽  
Calcium Carbonate ◽  
Zoledronic Acid ◽  
Bone Loss ◽  
Periodontal Disease ◽  
Phase Iii ◽  
Exclusion Criterion ◽  
Mineral Density ◽  
Absolute Change ◽  
One Year

e20611 Background: Treatment of lymphoma with alkylating agents and steroids causes bone loss and increased fracture risk. In addition, over half of all untreated lymphoma patients are osteopenic or osteoporotic at diagnosis. Pamidronate reduces bone loss and risk of vertebral fractures in lymphoma patients undergoing chemotherapy (CT). However, the effects of the more potent bisphosphonate (BP) zoledronic acid (ZA) in this setting are unknown. Therefore, we report on a phase III trial evaluating the effect of ZA on bone mineral density (B) in patients with newly-diagnosed lymphoma undergoing CT. Methods: In total, 72 patients will be randomized to either the control arm [calcium carbonate (1,200 mg orally/day) plus vitamin D (400 IU orally/day)], or the BP arm [calcium carbonate and vitamin D as in the control arm plus ZA (4 mg IV at baseline and at 6 months)]. The primary endpoint is the absolute change in B of the lumbar spine (LS) and femoral neck (FN) at baseline and 12 months. Results: Thus far, 112 patients have been screened for enrollment. Twenty-seven patients (24.1%) failed screening due to periodontal disease, a predetermined exclusion criterion of the study. To date, 14 patients in the control arm and 9 patients in the BP arm have completed the one-year follow up period including baseline and one-year B evaluations. Comparing patients in the control arm to those in the BP arm, the average absolute change in B at the LS was -0.048 g/cm2 vs. 0.0093 g/cm2 (p=0.005), at the left FN was -0.039 g/cm2 vs. 0.0074 g/cm2 (p=0.01), and at the right FN was -0.043 g/cm2 vs. 0.0211 g/cm2 (p<0.001), respectively. There have been no therapy-related serious adverse events or skeletal fractures in either arm. Conclusions: ZA in combination with calcium carbonate and vitamin D improves the B of patients with lymphoma undergoing CT. Given the incidence of below-average pre-treatment B and the known deleterious effects of lymphoma therapy on bone density, baseline B evaluation is warranted in all lymphoma patients. The high rate of periodontal disease in this patient population emphasizes the need for careful dental evaluation prior to BP therapy given the well-described, albeit rare, risk of osteonecrosis of the jaw from ZA. [Table: see text]

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