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A single administration of ZOL after discontinuation of ODN is beneficial in suppressing bone turnover and maintaining BMD for up to 1 year in osteoporosis patients.
According to a recent study published in 'Osteoporosis International', the treatment with zoledronic acid (ZOL) 5 mg helped maintain the bone turnover markers (BTMS) in the premenopausal range and prevented bone loss in women formerly treated with odanacatib (ODN).
Due to the high risk of cardiovascular events, development of odanacatib (ODN), a cathepsin K inhibitor used for the treatment of osteoporosis was ceased. The participants from the LOFT trial in Denmark were offered treatment using ZOL as the treatment is considered reversible.
A total of 67 postmenopausal women were treated using ZOL 5 mg with a follow-up of 12 months. Out of these, 39 received ODN for seven years, and 28 received a placebo for five years and ODN for two years. After ZOL, the bone turnover markers (BTM) were calculated at 3, 6, and 12 months. DXA of spine and hip were executed at the time of ZOL treatment and after 12 months.
A.S. Koldkjær Sølling et
al. found that the BMD at the lumbar spine increased by 2.8 ± 0.9%
(mean ± SEM) from baseline to month 12 within the entire study
population. No significant change in BMD was observed at the total
hip or femoral neck. No difference was seen in the changes in BMD
from baseline to 12 months between the two groups at any site. After
ZOL, CTX surged by 107 ± 9%, PINP by 102 ± 16%, osteocalcin
by 32 ± 6% and BSAP by 79 ± 37% between 3 - 12 months. BTM
was still within the premenopausal reference range at month 12.
During the year after the ZOL administration, S-25-hydroxyvitamin D
increased, while PTH and eGFR decreased.
Osteoporosis International
Treatment with zoledronic acid subsequent to odanacatib prevents bone loss in postmenopausal women with osteoporosis
Koldkjær Sølling et al.
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