Zoledronic acid (Zometa) use in bone disease

Zoledronic acid (Zometa) is the most recent addition to the clinically available bisphosphonates. Clinical benefits in metabolic, as well as cancer-related bone disease have been observed. In addition to its profound antiosteoclast effects, it has demonstrated anticancer effects in preclinical models. Zoledronic acid has been evaluated in randomized, double-blind clinical trials of osteoporosis, Paget's disease of bone, and metastatic, osteolytic and osteoblastic bone disease. Antiosteoclast activity has been demonstrated by reductions in the bone breakdown products N-telopeptide, C-telopeptide and deoxypyridinoline. Bone mineral density, measured by dual energy x-ray absorptometry, is increased with administration of zoledronic acid in postmenopausal osteoporosis. Clinical benefit in cancer includes improvement in bone pain, reductions in skeletal events and delay in time-to-first-skeletal-events. These zoledronic acid treatment benefits have been demonstrated in patients with multiple myeloma, breast, prostate and lung cancer, and other solid tumors.