Document Detail


A single infusion of zoledronic acid produces sustained remissions in Paget's disease - data to 6.5 years.
MedLine Citation:
PMID:  21638319     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Two trials have shown that a single 5mg infusion of zoledronic acid achieves much higher response rates in Paget's disease of bone than risedronate. The duration of this effect is unknown. We have conducted an open, follow-up of responders from the two trials (152 originally treated with zoledronic acid, 115 with risedronate) up to 6.5 years without further intervention. Endpoints were times to relapse (return of serum total alkaline phosphatase activity (ALP) to within 20% of the pre-treatment value) or loss of response (response = normalization of ALP or ≥75% reduction in its excess). Bone turnover markers were lower in the zoledronic acid group throughout follow-up, with mean ALP remaining within the reference range in these subjects, whereas the mean in the risedronate group was above normal from 1 year. Relapse rates were substantially greater in the risedronate group (23/115, 20%) than in those treated with zoledronic acid (1/152, 0.7%, P <0.001), and loss of response occurred in 19 (12.5%) zoledronic acid patients, compared with 71 (62%) (P <0.0001). Risk ratios for relapse and loss of response in zoledronic acid patients were 0.02 (95% CI, 0.00, 0.18) and 0.12 (0.07, 0.19), respectively. Changes from baseline in quality of life, assessed using SF-36 scores, were more positive in the zoledronic acid group across the follow-up period (P = 0.01). Bone markers at 6 months were predictive of response duration. The present data demonstrate an unprecedented duration of remission of Paget's disease following treatment with zoledronic acid, accompanied by improved quality of life. © 2011 American Society for Bone and Mineral Research.
Authors:
Ian R Reid; K Lyles; Guoqin Su; Jp Brown; Jp Walsh; J Del Pino-Montes; Pd Miller; Wd Fraser; S Cafoncelli; C Bucci-Rechtweg; Dj Hosking
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-6-2
Journal Detail:
Title:  Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research     Volume:  -     ISSN:  1523-4681     ISO Abbreviation:  -     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-6-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8610640     Medline TA:  J Bone Miner Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 American Society for Bone and Mineral Research.
Affiliation:
University of Auckland, Auckland, New Zealand. i.reid@auckland.ac.nz.
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