scholarly journals Role of zoledronic acid in treatment of osteoporosis and prevention of fractures

2022 ◽  
pp. 102-109
Author(s):  
A. V. Krivova ◽  
V. P. Zakharov ◽  
A. N. Sharov

Introduction. One of the causes of primary disability and high mortality, among patients with osteoporosis, are fractures that occur with minimal trauma, as a rule, it is a fall from the height of one’s own height. The final link in the chain of preventive measures to reduce the frequency of osteoporosis and fractures on its background is the introduction of pharmacological correction of bone deficiency into the practical activity of an orthopedic traumatologist. Currently, there are several drugs that can change the disturbed metabolism. For example, the use of zoledronic acid significantly reduces the risk of fractures.Aim: to study the effect of zoledronic acid on bone mineral density in patients with osteoporosis complicated by a fracture of proximal end of the femur.Materials and methods. In a prospective cohort study, 14 patients received zoledronic acid for 2 years.Results. When comparing BMD L2-L4, it was revealed that a year after the start of treatment, its increase relative to the baseline value was 4.6%, but was statistically insignificant (0.86 ± 0.078 g/cm2 versus 0.90 ± 0.08 g/cm2, p > 0.05). After 2 years of treatment, the BMD of this segment increased, relative to the baseline values, by 12% and the differences became statistically significant (0.86 ± 0.078 g/cm2 compared to 0.97 ± 0.076 g/cm2, p < 0.05). The increase in BMD for the second year of treatment by 6% was statistically significantly different from the increase for the first year of treatment (0.90 ± 0.08 g/cm2 compared to 0.97 ± 0.076 g/cm2, p < 0.05).A comparative analysis of the basic units of the IPC hip after 1 and 2 years of treatment did not reveal significant differences: 0.7075 ± 0.046 g/cm2 compared to 0.7079 ± 0.034 g/cm2 and 0.70751 ± 0.046 g/cm2 compared to 0.6630 ± 0.97 g/cm2, p > 0.05. In any case, for 2 years not marked new vertebral body fractures. Only one patient had a fracture of the radius in the distal third. The quality of life, after 2 years, significantly improved on the scale of “habitual daily activities” (p = 0.007), decreased indicators on the scale of “anxiety” and “depression” (p > 0.05).Discussion. The study confirmed that even in the presence of pronounced bone loss, pharmacological correction of impaired remodeling reduces the risk of new fractures and improves the quality of life.Conclusion. Pharmacotherapy with zoledronic acid, in our study, confirmed its effectiveness in the treatment of osteoporosis.

2020 ◽  
pp. 153537022096875
Author(s):  
Sandra Kraljević Pavelić ◽  
Vedran Micek ◽  
Dragica Bobinac ◽  
Edo Bazdulj ◽  
Alessandra Gianoncelli ◽  
...  

The severity of osteoporosis in humans manifests in its high incidence and by its complications that diminish quality of life. A societal consequence of osteoporosis is the substantial burden that it inflicts upon patients and their families. Several bone-modifying drugs have been prescribed to patients with osteoporosis. However, evidence for their anti-fracture efficacy remains inconclusive. To the contrary, long-term use of anti-osteoporotic drugs such as bisphosphonates and Denosumab, an RANKL inhibitor, have resulted in adverse events. We now present an alternative and adjuvant approach for treatment of osteoporosis. The data derive from in vivo studies in an ovariectomized rat model and from a randomized double blind, placebo-controlled human clinical study. Both studies involved treatment with Panaceo Micro Activation (PMA)-zeolite-clinoptilolite, a defined cation exchange clinoptilolite, which clearly improved all bone histomorphometric parameters examined from ovariectomized animals, indicative for increased bone formation. Moreover, intervention with PMA-zeolite-clinoptilolite for one year proved safe in humans. Furthermore, patients treated with PMA-zeolite-clinoptilolite showed an increase in bone mineral density, an elevated level of markers indicative of bone formation, a significant reduction in pain, and significantly improved quality of life compared with patients in the control (placebo) group. These encouraging positive effects of PMA-zeolite-clinoptilolite on bone integrity and on osteoporosis warrant further evaluation of treatment with PMA-zeolite-clinoptilolite as a new alternative adjuvant therapy for osteoporosis.


2021 ◽  
pp. 62-63
Author(s):  
Neha Thakur ◽  
B.L. Mehra ◽  
Sunil Thakur ◽  
Anil Bhardwaj

Osteoporosis is an alarming issue in the society today. It is continuously increasing its signicance with increasing elderly population and is affecting both the sexes at different degrees. It is characterized by low bone mass with microarchitectural deterioration of bone leading to enhanced bone fragility, thus increasing the susceptibility to fracture. Taking into account the references available in various Ayurvedic classics it can be correlated to Asthikshaya. Asthikshaya occurs due to decrease in strength of Asthi Dhatu chiey due to Kala, Swabhava and Vata Prakopa. International Osteoporosis Foundation estimated that the annual direct cost of treating osteoporotic fractures has increased grossly. In India the general population is not much aware about the hazardous complications of osteoporosis. The modern pharmacological treatment is long and beyond the nancial reach of common people. Therefore the best way to deal with it is to prevent this as early as possible. To achieve this aim a clinical study was conducted to evaluate the effect of an Ayurvedic Formulation known as Eleg Fem capsules (Asthishrinkhalaadi Yoga) in osteoporotic patients. In the clinical trial 30 patients above the age of 40 years with low BMD T-Score were registered from OPD and IPD of Kayachikitsa department of Rajiv Gandhi Govt. Post Graduate Ayurvedic College and Hospital Paprola, Kangra. Out of 30 patients, 27 completed the trial and 3 patients were drop out. Criteria of assessment of patients was change in bone mineral density (BMD T- Score) and change in the score of Quality of Life Index Questionnaire for Osteoporosis (QUALEFFO-41). All the registered patients were given the formulation for 6 weeks. Improvement was observed with statistically signicant results on mean BMD TScore and moderately signicant result on Quality of Life Index scoring. The study revealed that the Eleg Fem capsules (Asthishrinkhalaadi Yoga) is a safe and effective therapy in the Osteoporotic patients.


2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Zengrui Zhang ◽  
Bin Shao ◽  
Yanzhao Li ◽  
Qiang Zan

The purpose of this study was to analyze the clinical experience of Zan Qiang, a famous doctor of Traditional Chinese Medicine in Shaanxi province, in the treatment of perimenopausal osteoporosis. Zan believed that the main etiology and pathogenesis of perimenopausal osteoporosis were "deficiency of kidney essence, decreased marrow and bone", "deficiency of liver and kidney" and "stasis caused by deficiency". Although it is a chronic physiological disease, and the pathological process is irreversible, the treatment groups of "tonifying kidney and filling essence", "tonifying liver and tonifying kidney" and "tonifying deficiency and promoting blood circulation" can significantly improve the symptoms of patients, slow down the progress of the disease and improve the quality of life of patients.


2020 ◽  
Author(s):  
Anett Vincze ◽  
Levente Bodoki ◽  
Katalin Szabó ◽  
Melinda Nagy-Vincze ◽  
Orsolya Szalmás ◽  
...  

Abstract Background: The prevalence of osteoporosis and risk of fractures is elevated in rheumatoid arthritis, but we have little information about the bone mineral density and fracture risk in patients with inflammatory myopathies. We intended to ascertain and compare fracture risk, bone mineral density (BMD) and the prevalence of vertebral fractures in patients with inflammatory myositis and rheumatoid arthritis (RA) and to assess the effect of prevalent fractures on the quality of life and functional capacity. Methods: Fifty-two patients with myositis and 43 patients with rheumatoid arthritis were included in the study. Fracture Risk was determined using FRAX® Calculation Tool developed by the University of Sheffield. Dual energy X-ray absorptiometry and bidirectional thoracolumbar radiographs were performed to assess BMD and vertebral fractures. Quality of life was measured with Short Form-36 (SF-36) and physical function assessment was performed using Health Assessment Questionnaire (HAQ). Results: We found a significantly elevated fracture risk in RA compared to myositis patients if the risk assessment was performed without the application of the BMD results. If BMD results and glucocorticoid dose adjustment were taken into account, the differences in fracture risk were no longer significant. The prevalence of osteoporosis was found to be significantly higher in the myositis group (7% vs. 13.5%, p: 0,045), but the fracture prevalence was similar in the two groups (75% vs. 68%). The fractures rates were associated with age in both groups, but not with cumulative dose of steroid and BMD results correlated with fracture prevalence only in the RA patients. The number of prevalent fractures was significantly correlated to poorer physical function in both groups, and poorer health status in the myositis group, but not in the RA group. Conclusions: Our findings suggest that inflammatory myopathies carry significantly elevated risk for osteoporosis and fractures. This higher risk is comparable to one detected with RA in studies and strongly affects the physical function and quality of life of patients. Therefore further efforts are required to make the fracture risk assessment reliable and to facilitate the use early preventive treatments.


2010 ◽  
Vol 2 ◽  
pp. CMT.S4947
Author(s):  
Sheila Anne Doggrell

Osteoporosis is the most common bone disease. Low levels of oestrogens or testosterone are risk factors for primary osteoporosis. The most common cause of secondary osteoporosis is glucocorticoid treatment, but there are many other secondary causes of osteoporosis. Osteoporosis can be secondary to anti-oestrogen treatment for hormone-sensitive breast cancer and to androgen-deprivation therapy for prostate cancer. Zoledronic acid is the most potent bisphosphonate at inhibiting bone resorption. In osteoporosis, zoledronic acid increases bone mineral density for at least a year after a single intravenous administration. The efficacy and safety of extended release (once-yearly) zoledronic acid in the treatment of osteoporosis is reviewed.


Author(s):  
Uta Hill ◽  
Jane Ashbrook ◽  
Charles Haworth

This chapter provides a comprehensive update on the prevention, recognition, and treatment of low bone mineral density in people with CF. As life expectancy improves, the extra-pulmonary complications of CF are becoming increasingly important to quality of life. Up to 25 per cent of CF patients have reduced bone mineral density in adulthood, leading to the development of fragility fractures which cause pain, thereby interfering with airway clearance and predisposing to pulmonary infection. Osteoporosis can be a relative contraindication for lung transplantation. Other important musculoskeletal issues including CF arthropathy, growth, and urinary incontinence are covered. CF arthropathy is a non-erosive episodic sero-negative arthritis, often difficult to treat and which may require specialist input. Urinary incontinence is common girls and women with CF and has a negative impact on quality of life and ability to complete therapies. The pathophysiology and management of urinary incontinence are discussed.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Sam Chidi Ibeneme ◽  
Franklin Onyedinma Irem ◽  
Nneka Ifeyinwa Iloanusi ◽  
Amarachi Destiny Ezuma ◽  
Fortune Elochukwu Ezenwankwo ◽  
...  

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