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Related Concept Videos

Bone Disorders01:29

Bone Disorders

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Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
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Bone Remodeling01:40

Bone Remodeling

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Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.
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Osteoclasts in Bone Remodeling01:31

Osteoclasts in Bone Remodeling

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Osteoclasts are cells responsible for bone resorption and remodeling. They originate from hematopoietic progenitor cells present in the bone marrow. Numerous progenitor cells fuse to form multinucleated cells, each with 10-20 nuclei. A single osteoclast has a diameter of 150 to 200 µM. These cells have ruffled borders that break down the underlying bone tissue and release minerals such as calcium into the blood in bone resorption. Osteoclasts cling to bones with their ruffled edges during...
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  5. Biomedical And Clinical Sciences
  7. Oncology And Carcinogenesis
  9. Predictive And Prognostic Markers
  11. Intermittent Dosing Of Zoledronic Acid Based On Bone Turnover Marker Assessment Reduces Vertebral And Non-vertebral Fractures.
  1. Home
  3. Research Domains
  5. Biomedical And Clinical Sciences
  7. Oncology And Carcinogenesis
  9. Predictive And Prognostic Markers
  11. Intermittent Dosing Of Zoledronic Acid Based On Bone Turnover Marker Assessment Reduces Vertebral And Non-vertebral Fractures.

Related Experiment Video

Semiautomated Longitudinal Microcomputed Tomography-based Quantitative Structural Analysis of a Nude Rat Osteoporosis-related Vertebral Fracture Model
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Semiautomated Longitudinal Microcomputed Tomography-based Quantitative Structural Analysis of a Nude Rat Osteoporosis-related Vertebral Fracture Model

Published on: September 28, 2017

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Intermittent dosing of zoledronic acid based on bone turnover marker assessment reduces vertebral and non-vertebral fractures.

Tove Tveitan Borgen1, Sindre Lee-Ødegård2, Barbara Fink Eriksen3,4

  • 1Department of Rheumatology, Drammen Hospital, N-3004 Drammen, Norway.

JBMR Plus
|June 28, 2024

View abstract on PubMed

Summary
This summary is machine-generated.

Zoledronic acid (ZOL) dosing guided by serum procollagen type 1 N-terminal propeptide (P1NP) levels effectively increased bone mineral density and reduced fractures over 8 years. This approach, using P1NP to guide intermittent ZOL infusions, reduced treatment frequency and potential side effects.

Keywords:
antiresorptivesbiochemical markers of bone turnover

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Area of Science:

  • Endocrinology
  • Osteoporosis Research
  • Pharmacology

Background:

  • Zoledronic acid (ZOL) is effective for preventing fractures in osteoporosis.
  • Bone turnover markers, particularly procollagen type 1 N-terminal propeptide (P1NP), can predict treatment efficacy.
  • Previous studies show similar antifracture efficacy with ZOL administered annually for 3 years or once over 3 years.

Purpose of the Study:

  • To investigate the impact of intravenous ZOL dosing guided by serum P1NP (S-P1NP) levels on bone mineral density (BMD) and fracture rates.
  • To evaluate the long-term effects of an individualized ZOL treatment regimen based on S-P1NP monitoring.

Main Methods:

  • Retrospective cohort study of 202 osteoporosis patients treated with ZOL for an average of 4.4 years (range 2-8 years).
  • S-P1NP and BMD were measured at baseline and every 1-2 years.
  • A new ZOL infusion was administered if S-P1NP levels exceeded 35 μg/L.

    • Main Results:

    • BMD increased by 6.2% in the first 2 years and remained stable thereafter.
    • Median S-P1NP levels decreased initially and then stabilized.
    • Significant reductions in fracture rates were observed: vertebral fractures (OR 0.61) and nonvertebral fractures (OR 0.23).
    • Only 39% of patients required more than one ZOL infusion over the study period.

    Conclusions:

    • Intermittent intravenous ZOL dosing guided by S-P1NP assessment (cut-off 35 μg/L) effectively improves BMD and reduces fractures over 8 years.
    • This individualized approach leads to less frequent ZOL administration, potentially lowering healthcare costs and reducing risks of rare side effects like osteonecrosis of the jaw and atypical femoral fractures.