Role of zoledronic acid in the prevention and treatment of osteoporosis

Abstract

Taken once a year, intravenous zoledronic acid (Zol) (Reclast^® or Aclasta^®) is a third-generation nitrogen-containing bisphosphonate that is effective compared with placebo in reducing the risk of fractures in patients with postmenopausal osteoporosis and recent low-trauma hip fracture. In glucocorticoid-induced osteoporosis, there is no significant difference between Zol and risedronate for new fractures. Improvements in bone mineral density and early reduction of bone remodeling markers are observed in postmenopausal osteoporosis, recent low-trauma hip fracture, and glucocorticoid-induced osteoporosis. Given that Zol is generally well tolerated and very convenient, it is an interesting therapeutic option for aging patients who take multiple oral drugs, who have adherence or gastrointestinal tolerance issues, and who have an indication for oral bisphosphonates. Zol is not recommended for patients with severe renal impairment. Vitamin D deficiency should be corrected before the administration of Zol.

Keywords:

• zoledronic acid
• osteoporosis
• elderly

Acknowledgements

The authors would like to thank Marylene Joyal for her expert secretarial assistance in the preparation of the manuscript.

Disclosure

Dr Ste-Marie has received grants and research support, worked as a consultant and acted as an advisor for Alliance for better bone health (Procter & Gamble Pharmaceuticals and sanofi aventis Canada Inc.), Amgen Canada, AstraZeneca Inc, Eli Lilly Inc, GlaxoSmith Kline Inc, Merck Frost, Novartis Pharma Inc, Servier Inc, Pfizer Canada Inc, Zelos Therapeutics Inc and Warner Chilcott. Drs Räkel and Boucher report no conflicts of interest in this work.