Bone Mineral Density and Bone Turnover 10 Years After a Single 5 mg Dose or Two 5-Yearly Lower Doses of Zoledronate in Osteopenic Older Women: An Open-Label Extension of a Randomized Controlled Trial.


Journal

Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
ISSN: 1523-4681
Titre abrégé: J Bone Miner Res
Pays: United States
ID NLM: 8610640

Informations de publication

Date de publication:
01 2022
Historique:
revised: 13 09 2021
received: 12 05 2021
accepted: 26 09 2021
pubmed: 30 9 2021
medline: 15 3 2022
entrez: 29 9 2021
Statut: ppublish

Résumé

Intravenous zoledronate reduces fracture risk (5 mg at 18-month intervals) and prevents bone loss (doses of 1 to 5 mg for 3 to >5 years), but the duration of action of a single 5 mg dose and the effects of lower doses beyond 5 years are unknown. We report the second open-label extension (years 5 to 10) of a 2-year randomized, multidose, placebo-controlled, double-blinded trial. A total of 116 older women who completed 5 years of participation either continued observation without further treatment (zoledronate 5 mg and placebo at baseline) or received repeat doses of 1 or 2.5 mg zoledronate (zoledronate 1 mg and zoledronate 2.5 mg at baseline, respectively). Outcomes were spine, hip, and total body bone mineral density (BMD) and serum markers of bone turnover. After a single 5 mg dose of zoledronate, mean BMD at the lumbar spine and total hip was maintained at or above baseline levels for 9 and 10 years, respectively. The mean level of the bone resorption marker β-C-terminal telopeptide of type I collagen (β-CTX) was at least 25% lower than that in the placebo group for 9 years. In women administered 5-yearly doses of 2.5 mg zoledronate, mean BMD at the total hip and lumbar spine was maintained at or above baseline levels for 9 and 10 years, respectively. Redosing with 1 or 2.5 mg zoledronate at 5 years reduced bone turnover markers for 3 to 4 years. BMD increased for 3 to 4 years after redosing with 1 mg zoledronate. In the group given 5-yearly 2.5 mg zoledronate, β-CTX was at least 20% lower than that in the placebo group for 10 years. Both a single baseline 5 mg dose of zoledronate and 5-yearly doses of 1 and 2.5 mg zoledronate prevented bone loss at hip and spine for 8 to 10 years in older postmenopausal women. Clinical trials to evaluate the effects on fracture risk of these very infrequent and lower doses of zoledronate are justified. © 2021 American Society for Bone and Mineral Research (ASBMR).

Identifiants

pubmed: 34585780
doi: 10.1002/jbmr.4453
doi:

Substances chimiques

Bone Density Conservation Agents 0
Diphosphonates 0
Imidazoles 0
Zoledronic Acid 6XC1PAD3KF

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

3-11

Commentaires et corrections

Type : CommentIn

Informations de copyright

© 2021 American Society for Bone and Mineral Research (ASBMR).

Références

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Auteurs

Andrew Grey (A)

Department of Medicine, University of Auckland, Auckland, New Zealand.

Mark J Bolland (MJ)

Department of Medicine, University of Auckland, Auckland, New Zealand.

Anne Horne (A)

Department of Medicine, University of Auckland, Auckland, New Zealand.

Borislav Mihov (B)

Department of Medicine, University of Auckland, Auckland, New Zealand.

Greg Gamble (G)

Department of Medicine, University of Auckland, Auckland, New Zealand.

Ian R Reid (IR)

Department of Medicine, University of Auckland, Auckland, New Zealand.

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