Background Osteoporosis (OP) is a systemic chronic disease caused by low bone mineral density mass and bone microarchitecture alteration, and is characterized by an increased skeletal fragility and fracture risk.
In the osteoporosis therapeutic arsenal bisphosphonate therapy is included, being the zoledronate treatment one with intravenous administration. Is a potent treatment and is indicated in post-menopausal OP and corticosteroid-induced OP.
Objectives To analyze the bone turnover and fracture incidence in post-menopausal and corticosteroid-induced OP patients with intravenous zoledronate therapy.
Methods Retrospective observational study in which data from OP patients treated with intravenous zoledronate therapy were collected, and that are included in a protocol of bone turnover biomarkers and fracture monitoring in the Rheumatology Department of HUP La Fe.
Analytical data of bone turnover, fracture incidence, other previous or concomitant antiosteoporotic treatment and possible adverse events from 2011 to 2014 were collected.
A Chi-square test and Logrank survival analysis were used for statistical analysis.
Results We included 178 OP patients from H.U.P La Fe classified as 103 post-menopausal OP and 75 secondary OP (18 with liver transplantation, 12 rheumatoid arthritis and 18 with other diagnosis). All, patients had vitamin D supplementation, and in 136 cases received calcium supplementation due to intolerances. 53 patients were treated previously with other bisphosphonate therapy, 19 with teriparatide, 14 with strontium ranelate, 2 with denosumab and 2 with hormone replacement therapy. In all of them zoledronate therapy was indicated due to previous therapies intolerance and/or fragility or minimal trauma fractures. In 53 cases zoledronate therapy was suspended, due to fractures in 8 of them. Since the beginning of zoledronate treatment a decrease in P1NP values of 72.6% (from 84ng/mL to 23ng/mL) and in bCTX values of 62.5% (from 0,4ng/mL to 0,15ng/mL) were observed.
18 fractures in all patients were identified (7 in post-menopausal OP and 11 in secondary OP), with a mean treatment interval of 24 months. The most frequent locations were femur (5) and radius (4). Statistical analysis predict whether fractures are likely to occur in patients with secondary OP (P=0.005).
Conclusions Zoledronate therapy improved bone turnover biomarkers scores, both in post-menopausal OP and in secondary OP patients. During zoledronate treatment fractures were identified in 10% of patients, and they are more likely to be present in secondary OP patients.
Disclosure of Interest None declared
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