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Intravenous zoledronic acid for the treatment of osteoporosis

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Abstract

Osteoporosis is a preventable disease characterized by loss of bone mineral density, progression to diminished skeletal integrity, extensive bone fragility, and an increased risk of fracture. Morbidity and mortality from osteoporosis are significant, and the public health costs are substantial. Although safe and effective therapy is available, the disease remains underdiagnosed and undertreated. Oral bisphosphonates such as alendronate, risedronate, and ibandronate are the current first-line therapy; however, adherence to treatment is suboptimal, largely because the treatment regimen is difficult to follow. The bisphosphonate zoledronic acid (zoledronate), 5 mg, is administered as an annual 15-minute intravenous infusion for the treatment of postmenopausal osteoporosis, assuring treatment compliance and persistence over the 12-month dosing interval. The drug is safe and generally well tolerated, and provides sustained anti-fracture efficacy at all relevant skeletal sites. Zoledronic acid has the potential to improve clinical outcomes by reducing the risk of fracture in patients with osteoporosis.

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References and Recommended Reading

  1. National Osteoporosis Foundation: Fast Facts on Osteoporosis. http://www.nof.org/osteoporosis/diseasefacts.htm. Accessed July 27, 2007.

  2. Reginster JY, Burlet N: Osteoporosis: a still increasing prevalence. Bone 2006, 38:S4–S9.

    Article  PubMed  Google Scholar 

  3. NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy: Osteoporosis prevention, diagnosis, and therapy. JAMA 2001, 285:785–795.

  4. Kanis JA, Johnell O, Oden A, et al.: Ten year probabilities of osteoporotic fractures according to BMD and diagnostic thresholds. Osteoporos Int 2001, 12:989–995.

    Article  PubMed  CAS  Google Scholar 

  5. Arden NK, Nevitt MC, Lane NE, et al.: Study of Osteoporotic Fractures Research Group. Osteoarthritis and risk of falls, rates of bone loss, and osteoporotic fractures. Arthritis Rheum 1999, 42:1378–1385.

    Article  PubMed  CAS  Google Scholar 

  6. Burge R, Dawson-Hughes B, Solomon DH, et al.: Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res 2007, 22:465–475.

    Article  PubMed  Google Scholar 

  7. Brenneman SK, Barrett-Connor E, Sajjan S, et al.: Impact of recent fracture on health-related quality of life in postmenopausal women. J Bone Miner Res 2006, 21:809–816.

    Article  PubMed  Google Scholar 

  8. Kanis JA, Johnell OA: Requirements for DXA for the management of osteoporosis in Europe. Osteoporos Int 2005, 16:229–238.

    Article  PubMed  CAS  Google Scholar 

  9. Gabriel SE, Tosteson AN, Leibson CL, et al.: Direct medical costs attributable to osteoporotic fractures. Osteoporos Int 2002, 13:323–330.

    Article  PubMed  CAS  Google Scholar 

  10. Gehlbach SH, Avrunin JS, Puleo E, Spaetyh R: Fracture risk and antiresorptive medication use in older women in the USA. Osteoporos Int 2007, 18:805–810.

    Article  PubMed  CAS  Google Scholar 

  11. Haussler B, Gothe H, Gold D, et al.: Epidemiology, treatment and costs of osteoporosis in Germany—the BoneEVA Study. Osteoporos Int 2007, 18:77–84.

    Article  PubMed  CAS  Google Scholar 

  12. Vestergaard P, Rejnmark L, Mosekilde L: Osteoporosis is markedly underdiagnosed: a nationwide study from Denmark. Osteoporos Int 2005, 16:134–141.

    Article  PubMed  Google Scholar 

  13. Kim N, Rowe BH, Raymond G, et al.: Underreporting of vertebral fractures on routine chest radiography. AJR Am J Roentgenol 2004, 182:297–300.

    PubMed  CAS  Google Scholar 

  14. Morris CA, Carrino JA, Lang P, et al.: Incidental vertebral fractures on chest radiographs. Recognition, documentation, and treatment. J Gen Intern Med 2006, 21:352–356.

    Article  PubMed  Google Scholar 

  15. Majumdar SR, Kim N, Colman I, et al.: Incidental vertebral fractures discovered with chest radiography in the emergency department: prevalence, recognition, and osteoporosis management in a cohort of elderly patents. Arch Intern Med 2005, 165:905–909.

    Article  PubMed  Google Scholar 

  16. Lewiecki EM: Review of guidelines for bone mineral density testing and treatment of osteoporosis. Curr Osteoporos Rep 2005, 3:75–83.

    Article  PubMed  Google Scholar 

  17. Black DM, Delmas PD, Eastell R, et al.: for the HORIZON Pivotal Fracture Trial: Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. N Engl J Med 2007, 356:1809–1822.

    Article  PubMed  CAS  Google Scholar 

  18. Black DM, Thompson DE, Bauer DC, et al.: Fracture risk reduction with alendronate in women with osteoporosis: the Fracture Intervention Trial. FIT Research Group. J Clin Endocrinol Metab 2000, 85:4118–4124.

    Article  PubMed  CAS  Google Scholar 

  19. Chesnut IC, Skag A, Christiansen C, et al.: Effects of oral ibandronate administered daily or intermittently on fracture risk in postmenopausal osteoporosis. J Bone Miner Res 2004, 19:1241–1249.

    Article  CAS  Google Scholar 

  20. Cummings SR, Black DM, Thompson DE, et al.: Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the Fracture Intervention Trial. JAMA 1998, 280:2077–2082.

    Article  PubMed  CAS  Google Scholar 

  21. Harris ST, Watts NB, Genant HK, et al.: Effects of risedronate treatment on vertebral and nonvertebral fractures in women with postmenopausal osteoporosis: a randomized controlled trial. Vertebral Efficacy with Risedronate Therapy (VERT) Study Group. JAMA 1999, 282:1344–1352.

    Article  PubMed  CAS  Google Scholar 

  22. McClung MR, Geusens P, Miller PD, et al.: Effect of risedronate on the risk of hip fracture in elderly women. Hip Intervention Program Study Group. N Engl J Med 2001, 344:333–340.

    Article  PubMed  CAS  Google Scholar 

  23. Reginster J, Minne HW, Sorensen OH, et al.: Randomized trial of the effects of risedronate on vertebral fractures in women with established postmenopausal osteoporosis. Vertebral Efficacy with Risedronate Therapy (VERT) Study Group. Osteoporos Int 2000, 11:83–91.

    Article  PubMed  CAS  Google Scholar 

  24. Cramer JA, Amonkar MM, Hebborn A, Altman R: Compliance and persistence with bisphosphonate dosing regimens among women with postmenopausal osteoporosis. Curr Med Res Opin 2005, 21:1453–1460.

    Article  PubMed  CAS  Google Scholar 

  25. Lo JC, Pressman AR, Omar MA, Ettinger B: Persistence with weekly alendronate therapy among postmenopausal women. Osteoporos Int 2006, 17:922–928.

    Article  PubMed  CAS  Google Scholar 

  26. Weiss TW, von Allmen H, Henderson SC, et al.: Persistency rates across weekly and monthly bisphosphonates: results from the IMS Health Longitudinal Prescription Database [poster P8.13]. Presented at the National Osteoporosis Foundation 7th International Symposium on Osteoporosis: Translating Research into Clinical Practice. Washington, DC; April 18–22, 2007.

  27. Caro JJ, Ishak KJ, Huybrechts KF, et al.: The impact of compliance with osteoporosis therapy on fracture rates in clinical practice. Osteoporos Int 2004, 15:1003–1008.

    Article  PubMed  Google Scholar 

  28. Huybrechts KF, Ishak KJ, Caro JJ: Assessment of compliance with osteoporosis treatment and its consequences in a managed care population. Bone 2006, 38:922–928.

    Article  PubMed  Google Scholar 

  29. Siris ES, Harris ST, Rosen CJ, et al.: Adherence to bisphosphonate therapy and fracture rates in osteoporotic women: relationship to vertebral and nonvertebral fractures from 2 US claims databases. Mayo Clin Proc 2006, 81:1013–1022.

    PubMed  Google Scholar 

  30. Recker RR, Gallagher R, MacCosbe PE: Effect of dosing frequency on bisphosphonate medication adherence in a large longitudinal cohort of women. Mayo Clin Proc 2005, 80:856–861.

    Article  PubMed  Google Scholar 

  31. Cooper A, Drake J, Brankin E, the PERSIST Investigators: Treatment persistence with once-monthly ibandronate and patient support vs. once-weekly alendronate: results from the PERSIST study. Int J Clin Pract 2006, 60:896–905.

    Article  PubMed  CAS  Google Scholar 

  32. Lyles K, Colon-Emeric C, Magaziner J, et al.: Zoledronic acid reduces clinical fractures and mortality after hip fracture. N Engl J Med 2007, 357:1799–1809.

    Article  PubMed  CAS  Google Scholar 

  33. McClung M, Recker R, Miller P, et al.: Intravenous zoledronic acid 5 mg in the treatment of postmenopausal women with low bone density previously treated with alendronate. Bone 2007, 41:122–128.

    Article  PubMed  CAS  Google Scholar 

  34. Gertz BJ, Holland SD, Kline WF, et al.: Studies of the oral bioavailability of alendronate. Clin Pharmacol Ther 1995, 58:288–298.

    Article  PubMed  CAS  Google Scholar 

  35. De Groen PC, Lubbe DF, Hirsch LJ, et al.: Esophagitis associated with use of alendronate. N Engl J Med 1996, 335:1016–1021.

    Article  PubMed  Google Scholar 

  36. Downey TW, Foltz SH, Boccuzzi SJ, et al.: Adherence and persistence associated with the pharmacologic treatment of osteoporosis in a managed care setting. South Med J 2006, 99:570–575.

    Article  PubMed  Google Scholar 

  37. Aclasta Package Insert. Basel, Switzerland: Novartis Pharmaceuticals; 2007.

  38. Khosla S, Burr D, Cauley J, et al.: Bisphosphonate-associated osteonecrosis of the jaw: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res 2007, 22:1479–1491.

    Article  PubMed  Google Scholar 

  39. Woo SB, Hellstein JW, Kalmar JR: Bisphosphonates and osteonecrosis of the jaws. Ann Intern Med 2006, 144:753–756.

    PubMed  CAS  Google Scholar 

  40. Sambrook P, Over I, Goss A, New Zealand Bone and Mineral Society, Osteoporosis Australia, Medical Oncology Group of Australia, and the Australian Dental Association: Bisphosphonates and osteonecrosis of the jaw. Clinical practice position. Aust Fam Physician 2006, 35:801–803.

    PubMed  Google Scholar 

  41. Felsenberg D, Hoffmeister B, Amling M, et al.: Kiefernekrosen nach hoch dosierter bisphosphonattherapie. Dtsch Arztebl 2006, 103:3078–3081.

    Google Scholar 

  42. National Osteoporosis Foundation: Osteoporosis Clinical Practice Guideline. http://www.nof.org/professionals/clinical.htm. Accessed July 27, 2007.

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Correspondence to E. Michael Lewiecki.

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Lewiecki, E.M. Intravenous zoledronic acid for the treatment of osteoporosis. Curr Osteoporos Rep 6, 17–23 (2008). https://doi.org/10.1007/s11914-008-0004-x

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