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"Pain. Joints. Spine." 1 (21) 2016

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Zoledronic acid in the therapy of steroid-induced osteoporosis in patients with inflammatory joints disease

Authors: Mytrokhina O. - Dnipropetrovsk Medical Academy, Dnipropetrovsk, Ukraine; Lysunets T. - Regional Hospital after I.I. Mechnikov, Dnipropetrovsk, Ukraine

Categories: Rheumatology, Traumatology and orthopedics

Sections: Medical forums

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The article was published on p. 79-80


Osteoporosis is the most common bone disease in humans, representing a major public health problem as outlined in Bone Health and Osteoporosis. The disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility. The disease often does not become clinically apparent until a fracture occurs. Although glucocorticosteroids may effectively be used in the management of many inflammatory conditions, their use is associated with significant morbidity and mortality. The bone loss and increased fracture risk are a common consequence of using glucocorticosteroid drugs. The most pressing issue remains the prevention of osteoporosis in patients with prolonged therapy by glucocorticosteroid. Oral bisphosphonates increase bone mineral density and reduce frequency of vertebral fractures. The role of Zoledronic acid (ZOL) for steroid-induced osteoporosis in patients with inflammatory joints disease remains debatable.

Objectives. We aimed to evaluate the effects of Zoledronic acid for steroid-induced osteoporosis in patients with inflammatory joints disease.
Methods. 30 patients (mean age — 59.30 ± 3.76 years) with inflammatory joints disease were enrolled. All patients were women and received glucocorticoid during more than 5 years (mean duration of treatment — 3.80 ± 0.67 years). Women had osteoporosis documented by either a lumbar spine T-score ≤ –2.5 or lumbar spine T-score ≤ –1.5 with 2 mild or 1 moderate prevalent vertebral fracture. 15 (50 %) patients received the standard treatment and Zoledronic acid 5 mg infusion once a year (study group), while 15 (50 %) (control group) — received only the standard treatment for 3 years. Visual Analog Scale (VAS), bone mineral density (BMD) were performed in all patients at baseline and at the end of the study.   
Results. VAS and BMD did not differ significantly between the groups. After 3 years of treatment with Zoledronic acid the incidence of symptoms, including arthralgia were significantly lower in the study in comparison of control groups (P = 0.01). The increase in BMD was greater in the study group than in the control group (P = 0.05). During 3 years among patients in the control group 33 % have compression fractures in compare with study group (P = 0.01).
Conclusion. Zoledronic acid is effective and safe for patients with glucocorticoid-induced osteoporosis in patients with inflammatory joints disease. Its administration may provide benefits for the reduction of hospitalizations and mortality in its population.   

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