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Zoledronic Acid Improves Bone Loss From Glucocorticoid Use

Once-per-year infusion found to be better than daily doses of risedronate for drug-induced bone loss

FRIDAY, April 10 (HealthDay News) -- A single yearly infusion of zoledronic acid improved bone mineral density better than daily doses of risedronate among patients at risk for osteoporosis due to glucocorticoid use for inflammatory or immune-mediated disorders, researchers report in the April 11 issue of The Lancet.

David M. Reid, M.D., of the University of Aberdeen in the United Kingdom, and colleagues carried out a one-year double-blind study involving 833 patients at 54 centers in 16 countries worldwide. The patients were randomized to receive either a single 5-mg intravenous infusion of zoledronic acid (n=416) or 5-mg daily oral doses of risedronate (n=417). Patients also were assigned to prevention or treatment subgroups depending on the length of time they had been on glucocorticoids. The percentage change of lumbar spine bone mineral density from baseline was calculated at one year.

Zoledronic acid increased lumbar spine bone mineral density in both the treatment subgroup (least-squares mean 4.06 percent) and prevention subgroup (2.60 percent) more than risedronate (least-squares mean 2.71 percent and 0.64 percent, respectively), the researchers report. Adverse events occurred more frequently with zoledronic acid, the authors note. More serious adverse events included pyrexia in the prevention subgroup and exacerbated rheumatoid arthritis in the treatment subgroup.

"A single 5-mg intravenous infusion of zoledronic acid is non-inferior, possibly more effective, and more acceptable to patients than is 5 mg of oral risedronate daily for prevention and treatment of bone loss that is associated with glucocorticoid use," the authors write.

The study was funded by Novartis Pharma, which markets zoledronic acid under the brand name Zometa, and several authors have financial ties to Novartis and other pharmaceutical companies.

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