Background The zolendronic acid (ZO) is indicated in the treatment of osteoporosis and Paget’s disease, as well as in the prevention of fractures. The adverse effect (AE) more prevalent is the flu-like syndrome 1-2 (fever, myalgia, headache, arthralgia) that occurs early after the infusion. Some studies have detected an increased number of arrhythmias (atrial fibrillation) in patients treated with ZO3. Likewise, there have been reports ofosteonecrosis of the jaw4, especially in cancer patients receiving high doses of the drug. It may also be related to atypical femoral fractures, attributed to a suppression of bone metabolism (“frozen bone”). Other AE are slight impairment of renal function, uveitis5 and hypocalcemia6.
Objectives To determine the prevalence of adverse effects after the administration of zoledronate in a number of patients of our unit.
Methods Retrospective, descriptive study of patients treated with zoledronate from 01/01/2006 to 01/01/2011. Demographic and clinical characteristics, as well as type of side effects, were analyzed.
Results 775 patients corresponding to a total of 1653 infusions of zoledronic acid with different indications were reported. There were 582 (75%) women and 193 (25%) men. The mean age was 68 (±12) years. 511 (66%) patients received ZO for senile osteoporosis, 165 (21%) patients for Corticosteroid-Induced Osteoporosis, and 96 (12%) patients for the treatment of Paget’s disease. In our cohort the prevalence of all AE was 4.9%. The main AE described were: flu-like syndrome in 32 patients (4%), osteonecrosis of the jaw in two patients (0.25%) and uveitis in two patients (0.25%). Bilateral atypical diaphysis fracture was objectified in 1 patient (0.12%). Reasons for treatment cessation were: medical indications in 34 patients (4.3%), side effects in 6 patients (0.75%) and ineffectiveness in 1 patient.
Conclusions The use of zoledronic acid is safe in our study. The most frequent AE was the flu-like syndrome with a lower prevalence than in other series1. The reason could be that we collected only the cases that alarmed the patients. As in other series (4,5,6), the prevalence of the rest of AE described (osteonecrosis of the jaw, uveitis, atypical diaphysis fractures) was very low. No cases of renal toxicity, symptomatic arrhythmias, or hypocalcemia were found.
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Disclosure of Interest None Declared
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