medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-21-163-173medsovet-7219Research ArticleРЕВМАТОЛОГИЯRHEUMATOLOGYЗоледроновая кислота при остеопорозе и низкоэнергетических переломах, осложняющих его течениеZoledronic acid for osteoporosis and associated low-energy fractureshttps://orcid.org/0000-0002-2726-8758РодионоваС. С.RodionovaS. S.

Родионова Светлана Семеновна, д.м.н., профессор, руководитель научного отдела метаболических остеопатий и опухолей костей

127299, Москва, ул. Приорова, д. 10

Svetlana S. Rodionova, Dr. Sci. (Med.), Professor, Head of the Scientific Department of Metabolic Osteopathies and Bone Tumors 

10, Priorov St., Moscow, 127299

rod06@inbox.ruhttps://orcid.org/0000-0002-4216-8800КолондаевА. Ф.KolondaevA. F.

Колондаев Александр Федорович, к.м.н., врач – травматолог-ортопед, старший научный сотрудник научного отдела метаболических остеопатий и опухолей костей

127299, Москва, ул. Приорова, д. 10

Alexander F. Kolondaev, Cand. Sci. (Med.), Orthopedic Traumatologist, Senior Researcher of the Scientific Department of Metabolic Osteopathies and Bone Tumors 

10, Priorov St., Moscow, 127299

klndff@inbox.ruhttps://orcid.org/0000-0002-2789-6172ТоргашинА. Н.TorgashinA. N.

Торгашин Александр Николаевич, к.м.н., врач – травматолог-ортопед, старший научный сотрудник научного отдела метаболических остеопатий и опухолей костей

127299, Москва, ул. Приорова, д. 10

Alexander N. Torgashin, Cand. Sci. (Med.), Orthopedic Traumatologist, Senior Researcher of the Scientific Department of Metabolic Osteopathies and Bone Tumors 

10, Priorov St., Moscow, 127299

alexander.torgashin@gmail.comhttps://orcid.org/0000-0001-5463-9158СоломянникИ. А.SolomyannikI. A.

Соломянник Ирина Анатольевна, к.м.н., врач – травматолог-ортопед, начальник управления по реализации функций национального медицинского исследовательского центра

127299, Москва, ул. Приорова, д. 10

Irina А. Solomyannik, Cand. Sci. (Med.), Orthopedic Traumatologist, Head of the Department for the Implementation of the Functions of the National Medical Research Center 

10, Priorov St., Moscow, 127299

SolomyannikIA@cito-priorov.ruНациональный медицинский исследовательский центр травматологии и ортопедии имени Н.Н. ПриороваРоссияPriorov National Medical Research Center of Traumatology and OrthopedicsRussian Federation202219112022021163173Copyright © Родионова С.С., Колондаев А.Ф., Торгашин А.Н., Соломянник И.А., 20222022Родионова С.С., Колондаев А.Ф., Торгашин А.Н., Соломянник И.А.Rodionova S.S., Kolondaev A.F., Torgashin A.N., Solomyannik I.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7219

Золедроновая кислота – аминосодержащий бисфосфонат третьего поколения, применяется для лечения больных остеопорозом более 15 лет. За эти годы многочисленные экспериментальные и клинические исследования доказали высокую эффективность препарата при остеопорозе как у женщин различных возрастных групп, так и у мужчин при первичном и вторичном остеопорозе, у пациентов с разной выраженностью потери массы костной ткани и степенью риска переломов. Доказано, что внутривенные инфузии золедроновой кислоты приводят к быстрому росту массы костной ткани, существенному снижению риска низкоэнергетических переломов тел позвонков, проксимального отдела бедренной кости и в целом невертебральных переломов. Тем не менее в последние годы использование препарата значительно снизилось, что связывают как с недостаточной осведомленностью врачей первичного звена о возможностях данного препарата, так и с опасением таких осложнений его применения, как атипичные переломы и остеонекроз челюстных костей. Представленный обзор предназначен для повышения знаний врачей относительно механизма действия золедроновой кислоты, схем назначения препарата при различных формах остеопороза и переломах на его фоне. На приведенном клиническом примере показана способность золедроновой кислоты увеличивать массу не только губчатой, но и кортикальной кости проксимального отдела бедренной кости, что повышает роль золедроновой кислоты в профилактике повторных переломов. Кроме этого, пролонгированный эффект препарата позволяет по достижении терапевтического эффекта снизить частоту назначения по принципу «лекарственных каникул», сократив экономические затраты и медико-социальную нагрузку.

Zoledronic acid is a third-generation amino-containing BF that has been used to treat patients with osteoporosis for more than 15 years. Over the years, numerous experimental and clinical studies have proven the high efficacy of the drug in osteoporosis, both in women of various age groups, and in men, with primary and secondary osteoporosis, in patients with varying degrees of bone loss and risk of fractures. Intravenous infusions of zoledronic acid have been shown to result in a rapid gain of bone mass, a significant reduction in the risk of low-energy fractures of the vertebrae (spine), proximal femoral and nonvertebral fractures on the whole. However, in recent years, the use of the drug has significantly decreased, which is associated both with the lack of awareness of primary care physicians about the possibilities of this drug, and the fear of such complications of its use as atypical fractures and osteonecrosis of the jaw bones. The presented review aims to increase the knowledge of physicians regarding the mechanism of action of zoledronic acid, the regimens for prescribing the drug in various forms of osteoporosis and fractures against its background. The given clinical example shows the ability of zoledronic acid (osteostatics) to increase the mass of not only cancellous, but also the cortical bone of the proximal femur, which increases the role of zoledronic acid in the prevention of recurrent fractures. On top of that, the prolonged effect of the drug allows, when the desired therapeutic effect is achieved, to reduce the frequency of prescribing according to the ‘drug holiday’ principal, decreasing economic expenditures and medical and social burden.

золедроновая кислотабисфосфонатыостеопорознизкоэнергетические переломыпрофилактика повторных переломовzoledronic acidbisphosphonatesosteoporosislow-energy fracturesprevention of repeated fracturesReferencesRussell R.G. Bisphosphonates: the first 40 years. Bone. 2011;49(1):2–19. https://doi.org/10.1016/j.bone.2011.04.022.Russell R.G. Bisphosphonates: the first 40 years. Bone. 2011;49(1):2–19. https://doi.org/10.1016/j.bone.2011.04.022.Rogers M.J., Mönkkönen J., Munoz M.A. Molecular mechanisms of action of bisphosphonates and new insights into their effects outside the skeleton. Bone. 2020;139:115493. https://doi.org/10.1016/j.bone.2020.115493.Rogers M.J., Mönkkönen J., Munoz M.A. Molecular mechanisms of action of bisphosphonates and new insights into their effects outside the skeleton. Bone. 2020;139:115493. https://doi.org/10.1016/j.bone.2020.115493.Pazianas M., van der Geest S., Miller P. Bisphosphonates and bone quality. Bonekey Rep. 2014;3:529. https://doi.org/10.1038/bonekey.2014.24.Pazianas M., van der Geest S., Miller P. Bisphosphonates and bone quality. Bonekey Rep. 2014;3:529. https://doi.org/10.1038/bonekey.2014.24.Cui P., Liu H., Sun J., Amizuka N., Sun Q., Li M. Zoledronate promotes bone formation by blocking osteocyte-osteoblast communication during bone defect healing. Histol Histopathol. 2018;33(1):89–99. https://doi.org/10.14670/HH-11-893.Cui P., Liu H., Sun J., Amizuka N., Sun Q., Li M. Zoledronate promotes bone formation by blocking osteocyte-osteoblast communication during bone defect healing. Histol Histopathol. 2018;33(1):89–99. https://doi.org/10.14670/HH-11-893.Dhillon S. Zoledronic Acid (Reclast®, Aclasta®): A review in osteoporosis. Drugs. 2016;76(17):1683–1697. https://doi.org/10.1007/s40265-016-0662-4.Dhillon S. Zoledronic Acid (Reclast®, Aclasta®): A review in osteoporosis. Drugs. 2016;76(17):1683–1697. https://doi.org/10.1007/s40265-016-0662-4.Takimoto R., Suzawa T., Yamada A., Sasa K., Miyamoto Y., Yoshimura K. et al. Zoledronate promotes inflammatory cytokine expression in human CD14- positive monocytes among peripheral mononuclear cells in the presence of γδ T cells. Immunology. 2021;162(3):306–313. https://doi.org/10.1111/imm.13283.Takimoto R., Suzawa T., Yamada A., Sasa K., Miyamoto Y., Yoshimura K. et al. Zoledronate promotes inflammatory cytokine expression in human CD14- positive monocytes among peripheral mononuclear cells in the presence of γδ T cells. Immunology. 2021;162(3):306–313. https://doi.org/10.1111/imm.13283.Recker R.R., Delmas P.D., Halse J., Reid I.R., Boonen S., García-Hernandez P.A. et al. Effects of intravenous zoledronic acid once yearly on bone remodeling and bone structure. J Bone Miner Res. 2008;23(1):6–16. https://doi.org/10.1359/jbmr.070906.Recker R.R., Delmas P.D., Halse J., Reid I.R., Boonen S., García-Hernandez P.A. et al. Effects of intravenous zoledronic acid once yearly on bone remodeling and bone structure. J Bone Miner Res. 2008;23(1):6–16. https://doi.org/10.1359/jbmr.070906.Black D.M., Delmas P.D., Eastell R., Reid I.R., Boonen S., Cauley J.A. et al. Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. N Engl J Med. 2007;356(18):1809–1822. https://doi.org/10.1056/NEJMoa067312.Black D.M., Delmas P.D., Eastell R., Reid I.R., Boonen S., Cauley J.A. et al. Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. N Engl J Med. 2007;356(18):1809–1822. https://doi.org/10.1056/NEJMoa067312.Delmas P.D., Munoz F., Black D.M., Cosman F., Boonen S., Watts N.B. et al. Effects of yearly zoledronic acid 5 mg on bone turnover markers and relation of PINP with fracture reduction in postmenopausal women with osteoporosis. J Bone Miner Res. 2009;24(9):1544–1551. https://doi.org/10.1359/jbmr.090310.Delmas P.D., Munoz F., Black D.M., Cosman F., Boonen S., Watts N.B. et al. Effects of yearly zoledronic acid 5 mg on bone turnover markers and relation of PINP with fracture reduction in postmenopausal women with osteoporosis. J Bone Miner Res. 2009;24(9):1544–1551. https://doi.org/10.1359/jbmr.090310.Saag K., Lindsay R., Kriegman A., Beamer E., Zhou W. A single zoledronic acid infusion reduces bone resorption markers more rapidly than weekly oral alendronate in postmenopausal women with low bone mineral density. Bone. 2007;40(5):1238–1243. https://doi.org/10.1016/j.bone.2007.01.016.Saag K., Lindsay R., Kriegman A., Beamer E., Zhou W. A single zoledronic acid infusion reduces bone resorption markers more rapidly than weekly oral alendronate in postmenopausal women with low bone mineral density. Bone. 2007;40(5):1238–1243. https://doi.org/10.1016/j.bone.2007.01.016.Black D.M., Reid I.R., Boonen S., Bucci-Rechtweg C., Cauley J.A., Cosman F. et al. The effect of 3 versus 6 years of zoledronic acid treatment of osteoporosis: a randomized extension to the HORIZON-Pivotal Fracture Trial (PFT). J Bone Miner Res. 2012;27(2):243–254. https://doi.org/10.1002/jbmr.1494.Black D.M., Reid I.R., Boonen S., Bucci-Rechtweg C., Cauley J.A., Cosman F. et al. The effect of 3 versus 6 years of zoledronic acid treatment of osteoporosis: a randomized extension to the HORIZON-Pivotal Fracture Trial (PFT). J Bone Miner Res. 2012;27(2):243–254. https://doi.org/10.1002/jbmr.1494.Black D.M., Reid I.R., Cauley J.A., Cosman F., Leung P.C., Lakatos P. et al. The effect of 6 versus 9 years of zoledronic acid treatment in osteoporosis: a randomized second extension to the HORIZON-Pivotal Fracture Trial (PFT). J Bone Miner Res. 2015;30(5):934–944. https://doi.org/10.1002/jbmr.2442.Black D.M., Reid I.R., Cauley J.A., Cosman F., Leung P.C., Lakatos P. et al. The effect of 6 versus 9 years of zoledronic acid treatment in osteoporosis: a randomized second extension to the HORIZON-Pivotal Fracture Trial (PFT). J Bone Miner Res. 2015;30(5):934–944. https://doi.org/10.1002/jbmr.2442.Jacques R.M., Boonen S., Cosman F., Reid I.R., Bauer D.C., Black D.M., Eastell R. Relationship of changes in total hip bone mineral density to vertebral and nonvertebral fracture risk in women with postmenopausal osteoporosis treated with once-yearly zoledronic acid 5 mg: the HORIZON-Pivotal Fracture Trial (PFT). J Bone Miner Res. 2012;27(8):1627–1634. https://doi.org/10.1002/jbmr.1644.Jacques R.M., Boonen S., Cosman F., Reid I.R., Bauer D.C., Black D.M., Eastell R. Relationship of changes in total hip bone mineral density to vertebral and nonvertebral fracture risk in women with postmenopausal osteoporosis treated with once-yearly zoledronic acid 5 mg: the HORIZON-Pivotal Fracture Trial (PFT). J Bone Miner Res. 2012;27(8):1627–1634. https://doi.org/10.1002/jbmr.1644.Shuai B., Shen L., Yang Y., Ma C., Zhu R., Xu X. Assessment of the impact of zoledronic acid on ovariectomized osteoporosis model using micro-CT scanning. PLoS ONE. 2015;10(7):e0132104. https://doi.org/10.1371/journal.pone.0132104.Shuai B., Shen L., Yang Y., Ma C., Zhu R., Xu X. Assessment of the impact of zoledronic acid on ovariectomized osteoporosis model using micro-CT scanning. PLoS ONE. 2015;10(7):e0132104. https://doi.org/10.1371/journal.pone.0132104.Burket J.C., Brooks D.J., MacLeay J.M., Baker S.P., Boskey A.L., van der Meulen M.C. Variations in nanomechanical properties and tissue composition within trabeculae from an ovine model of osteoporosis and treatment. Bone. 2013;52(1):326–36. https://doi.org/10.1016/j.bone.2012.10.018.Burket J.C., Brooks D.J., MacLeay J.M., Baker S.P., Boskey A.L., van der Meulen M.C. Variations in nanomechanical properties and tissue composition within trabeculae from an ovine model of osteoporosis and treatment. Bone. 2013;52(1):326–36. https://doi.org/10.1016/j.bone.2012.10.018.Gamsjaeger S., Buchinger B., Zwettler E., Recker R., Black D., Gasser J.A. et al Bone material properties in actively bone-forming trabeculae in postmenopausal women with osteoporosis after three years of treatment with once-yearly zoledronic acid. J Bone Miner Res. 2011;26(1):12–18. https://doi.org/10.1002/jbmr.180.Gamsjaeger S., Buchinger B., Zwettler E., Recker R., Black D., Gasser J.A. et al Bone material properties in actively bone-forming trabeculae in postmenopausal women with osteoporosis after three years of treatment with once-yearly zoledronic acid. J Bone Miner Res. 2011;26(1):12–18. https://doi.org/10.1002/jbmr.180.Gamsjaeger S., Hofstetter B., Zwettler E., Recker R., Gasser J.A., Eriksen E.F. et al. Effects of 3 years treatment with once-yearly zoledronic acid on the kinetics of bone matrix maturation in osteoporotic patients. Osteoporos Int. 2013;24(1):339–347. https://doi.org/10.1007/s00198-012-2202-8.Gamsjaeger S., Hofstetter B., Zwettler E., Recker R., Gasser J.A., Eriksen E.F. et al. Effects of 3 years treatment with once-yearly zoledronic acid on the kinetics of bone matrix maturation in osteoporotic patients. Osteoporos Int. 2013;24(1):339–347. https://doi.org/10.1007/s00198-012-2202-8.Nakamura T., Fukunaga M., Nakano T., Kishimoto H., Ito M., Hagino H. et al. Efficacy and safety of once-yearly zoledronic acid in Japanese patients with primary osteoporosis: two-year results from a randomized placebocontrolled double-blind study (ZOledroNate treatment in Efficacy to osteoporosis; ZONE study). Osteoporos Int. 2017;28(1):389–398. https://doi.org/10.1007/s00198-016-3736-y.Nakamura T., Fukunaga M., Nakano T., Kishimoto H., Ito M., Hagino H. et al. Efficacy and safety of once-yearly zoledronic acid in Japanese patients with primary osteoporosis: two-year results from a randomized placebocontrolled double-blind study (ZOledroNate treatment in Efficacy to osteoporosis; ZONE study). Osteoporos Int. 2017;28(1):389–398. https://doi.org/10.1007/s00198-016-3736-y.Wang C. Efficacy and safety of zoledronic acid for treatment of postmenopausal osteoporosis: a meta-analysis of randomized controlled trials. Am J Ther. 2017;24(5):e544–e552. https://doi.org/10.1097/MJT.0000000000000415.Wang C. Efficacy and safety of zoledronic acid for treatment of postmenopausal osteoporosis: a meta-analysis of randomized controlled trials. Am J Ther. 2017;24(5):e544–e552. https://doi.org/10.1097/MJT.0000000000000415.Anagnostis P., Stevenson J.C. Bisphosphonate drug holidays – when, why and for how long? Climacteric. 2015;18(Suppl. 2):32–38. https://doi.org/10.3109/13697137.2015.1099092.Anagnostis P., Stevenson J.C. Bisphosphonate drug holidays – when, why and for how long? Climacteric. 2015;18(Suppl. 2):32–38. https://doi.org/10.3109/13697137.2015.1099092.Anagnostis P., Paschou S.A., Mintziori G., Ceausu I., Depypere H., Lambrinoudaki I. et al. Drug holidays from bisphosphonates and denosumab in postmenopausal osteoporosis: EMAS position statement. Maturitas. 2017;101:23–30. https://doi.org/10.1016/j.maturitas.2017.04.008.Anagnostis P., Paschou S.A., Mintziori G., Ceausu I., Depypere H., Lambrinoudaki I. et al. Drug holidays from bisphosphonates and denosumab in postmenopausal osteoporosis: EMAS position statement. Maturitas. 2017;101:23–30. https://doi.org/10.1016/j.maturitas.2017.04.008.Nayak S., Greenspan S.L. Cost-effectiveness of 3 versus 6 years of zoledronic acid treatment before bisphosphonate holiday for women with osteoporosis. Osteoporos Int. 2022;33(1):229–238. https://doi.org/10.1007/s00198-021-06010-5.Nayak S., Greenspan S.L. Cost-effectiveness of 3 versus 6 years of zoledronic acid treatment before bisphosphonate holiday for women with osteoporosis. Osteoporos Int. 2022;33(1):229–238. https://doi.org/10.1007/s00198-021-06010-5.Ma S., Goh E.L., Jin A., Bhattacharya R., Boughton O.R., Patel B. et al. Longterm effects of bisphosphonate therapy: perforations, microcracks and mechanical properties. Sci Rep. 2017;7:43399. https://doi.org/10.1038/srep43399.Ma S., Goh E.L., Jin A., Bhattacharya R., Boughton O.R., Patel B. et al. Longterm effects of bisphosphonate therapy: perforations, microcracks and mechanical properties. Sci Rep. 2017;7:43399. https://doi.org/10.1038/srep43399.Lloyd A.A., Gludovatz B., Riedel C., Luengo E.A., Saiyed R., Marty E. et al. Atypical fracture with long-term bisphosphonate therapy is associated with altered cortical composition and reduced fracture resistance. Proc Natl Acad Sci U S A. 2017;114(33):8722–8727. https://doi.org/10.1073/pnas.1704460114.Lloyd A.A., Gludovatz B., Riedel C., Luengo E.A., Saiyed R., Marty E. et al. Atypical fracture with long-term bisphosphonate therapy is associated with altered cortical composition and reduced fracture resistance. Proc Natl Acad Sci U S A. 2017;114(33):8722–8727. https://doi.org/10.1073/pnas.1704460114.Heo Y.M., Park S.E., Cha S.M., Shin H.D., Choi J.K. Diagnostic criteria and treatment of atypical ulnar fractures associated with prolonged bisphosphonate therapy: multicenter case analysis. J Hand Surg Am. 2021:S0363– 5023(21)00481-0. https://doi.org/10.1016/j.jhsa.2021.08.001.Heo Y.M., Park S.E., Cha S.M., Shin H.D., Choi J.K. Diagnostic criteria and treatment of atypical ulnar fractures associated with prolonged bisphosphonate therapy: multicenter case analysis. J Hand Surg Am. 2021:S0363– 5023(21)00481-0. https://doi.org/10.1016/j.jhsa.2021.08.001.Black D.M., Condra K., Adams A.L, Eastell R. Bisphosphonates and the risk of atypical femur fractures. Bone. 2022;156:116297. https://doi.org/10.1016/j.bone.2021.116297.Black D.M., Condra K., Adams A.L, Eastell R. Bisphosphonates and the risk of atypical femur fractures. Bone. 2022;156:116297. https://doi.org/10.1016/j.bone.2021.116297.Black D.M., Abrahamsen B., Bouxsein M.L., Einhorn T., Napoli N. Atypical femur fractures: review of epidemiology, relationship to bisphosphonates, prevention, and clinical management. Endocr Rev. 2019;40(2):333–368. https://doi.org/10.1210/er.2018-00001.Black D.M., Abrahamsen B., Bouxsein M.L., Einhorn T., Napoli N. Atypical femur fractures: review of epidemiology, relationship to bisphosphonates, prevention, and clinical management. Endocr Rev. 2019;40(2):333–368. https://doi.org/10.1210/er.2018-00001.Kim H.Y. Review and update of the risk factors and prevention of antiresorptive-related osteonecrosis of the jaw. Endocrinol Metab (Seoul). 2021;36(5):917–927. https://doi.org/10.3803/EnM.2021.1170.Kim H.Y. Review and update of the risk factors and prevention of antiresorptive-related osteonecrosis of the jaw. Endocrinol Metab (Seoul). 2021;36(5):917–927. https://doi.org/10.3803/EnM.2021.1170.Mavi E., Hocaoglu P.T. Effects of a single intravaneous dose of zoledronic acid on bone healing following tooth extraction in ovariectomized rabbits. Saudi Dent J. 2021;33(7):724–730. https://doi.org/10.1016/j.sdentj.2020.03.016.Mavi E., Hocaoglu P.T. Effects of a single intravaneous dose of zoledronic acid on bone healing following tooth extraction in ovariectomized rabbits. Saudi Dent J. 2021;33(7):724–730. https://doi.org/10.1016/j.sdentj.2020.03.016.Williams D.W., Lee C., Kim T., Yagita H., Wu H., Park S. et al. Impaired bone resorption and woven bone formation are associated with development of osteonecrosis of the jaw-like lesions by bisphosphonate and anti-receptor activator of NF-κB ligand antibody in mice. Am J Pathol. 2014;184(11):3084–3093. https://doi.org/10.1016/j.ajpath.2014.07.010.Williams D.W., Lee C., Kim T., Yagita H., Wu H., Park S. et al. Impaired bone resorption and woven bone formation are associated with development of osteonecrosis of the jaw-like lesions by bisphosphonate and anti-receptor activator of NF-κB ligand antibody in mice. Am J Pathol. 2014;184(11):3084–3093. https://doi.org/10.1016/j.ajpath.2014.07.010.Everts-Graber J., Lehmann D., Burkard J.P., Schaller B., Gahl B., Häuselmann H. et al. Risk of osteonecrosis of the jaw under denosumab compared to bisphosphonates in patients with osteoporosis. J Bone Miner Res. 2022;37(2):340–348. https://doi.org/10.1002/jbmr.4472.Everts-Graber J., Lehmann D., Burkard J.P., Schaller B., Gahl B., Häuselmann H. et al. Risk of osteonecrosis of the jaw under denosumab compared to bisphosphonates in patients with osteoporosis. J Bone Miner Res. 2022;37(2):340–348. https://doi.org/10.1002/jbmr.4472.Yang G., Singh S., McDonough C.W., Lamba J.K., Hamadeh I., Holliday L.S. et al. Genome-wide association study identified chromosome 8 locus associated with medication-related osteonecrosis of the jaw. Clin Pharmacol Ther. 2021;110(6):1558–1569. https://doi.org/10.1002/cpt.2397.Yang G., Singh S., McDonough C.W., Lamba J.K., Hamadeh I., Holliday L.S. et al. Genome-wide association study identified chromosome 8 locus associated with medication-related osteonecrosis of the jaw. Clin Pharmacol Ther. 2021;110(6):1558–1569. https://doi.org/10.1002/cpt.2397.Yang G., Collins J.M., Rafiee R., Singh S., Langaee T., McDonough C.W. et al. SIRT1 gene SNP rs932658 is associated with medication-related osteonecrosis of the jaw. J Bone Miner Res. 2021;36(2):347–356. https://doi.org/10.1002/jbmr.4185.Yang G., Collins J.M., Rafiee R., Singh S., Langaee T., McDonough C.W. et al. SIRT1 gene SNP rs932658 is associated with medication-related osteonecrosis of the jaw. J Bone Miner Res. 2021;36(2):347–356. https://doi.org/10.1002/jbmr.4185.Curtis J.R., Saag K.G., Arora T., Wright N.C., Yun H., Daigle S. et al. Duration of bisphosphonate drug holidays and associated fracture risk. Med Care. 2020;58(5):419–426. https://doi.org/10.1097/MLR.0000000000001294.Curtis J.R., Saag K.G., Arora T., Wright N.C., Yun H., Daigle S. et al. Duration of bisphosphonate drug holidays and associated fracture risk. Med Care. 2020;58(5):419–426. https://doi.org/10.1097/MLR.0000000000001294.Nayak S., Greenspan S.L. A systematic review and meta-analysis of the effect of bisphosphonate drug holidays on bone mineral density and osteoporotic fracture risk. Osteoporos Int. 2019;30(4):705–720. https://doi.org/10.1007/s00198-018-4791-3.Nayak S., Greenspan S.L. A systematic review and meta-analysis of the effect of bisphosphonate drug holidays on bone mineral density and osteoporotic fracture risk. Osteoporos Int. 2019;30(4):705–720. https://doi.org/10.1007/s00198-018-4791-3.Naylor K.E., McCloskey E.V., Jacques R.M., Peel N.F.A., Paggiosi M.A., Gossiel F. et al. Clinical utility of bone turnover markers in monitoring the withdrawal of treatment with oral bisphosphonates in postmenopausal osteoporosis. Osteoporos Int. 2019;30(4):917–922. https://doi.org/10.1007/s00198-018-04823-5.Naylor K.E., McCloskey E.V., Jacques R.M., Peel N.F.A., Paggiosi M.A., Gossiel F. et al. Clinical utility of bone turnover markers in monitoring the withdrawal of treatment with oral bisphosphonates in postmenopausal osteoporosis. Osteoporos Int. 2019;30(4):917–922. https://doi.org/10.1007/s00198-018-04823-5.Colón-Emeric C.S., Lee R.H. Bisphosphonate holidays: using cost-effectiveness analysis for the “yes, but” questions. Osteoporos Int. 2021;32(12):2389–2390. https://doi.org/10.1007/s00198-021-06064-5.Colón-Emeric C.S., Lee R.H. Bisphosphonate holidays: using cost-effectiveness analysis for the “yes, but” questions. Osteoporos Int. 2021;32(12):2389–2390. https://doi.org/10.1007/s00198-021-06064-5.Hayes K.N., Winter E.M., Cadarette S.M., Burden A.M. Duration of bisphosphonate drug holidays in osteoporosis patients: a narrative review of the evidence and considerations for decision-making. J Clin Med. 2021;10(5):1140. https://doi.org/10.3390/jcm10051140.Hayes K.N., Winter E.M., Cadarette S.M., Burden A.M. Duration of bisphosphonate drug holidays in osteoporosis patients: a narrative review of the evidence and considerations for decision-making. J Clin Med. 2021;10(5):1140. https://doi.org/10.3390/jcm10051140.Boonen S., Black D.M., Colón-Emeric C.S., Eastell R., Magaziner J.S., Eriksen E.F. et al. Efficacy and safety of a once-yearly intravenous zoledronic acid 5 mg for fracture prevention in elderly postmenopausal women with osteoporosis aged 75 and older. J Am Geriatr Soc. 2010;58(2):292–299. https://doi.org/10.1111/j.1532-5415.2009.02673.x.Boonen S., Black D.M., Colón-Emeric C.S., Eastell R., Magaziner J.S., Eriksen E.F. et al. Efficacy and safety of a once-yearly intravenous zoledronic acid 5 mg for fracture prevention in elderly postmenopausal women with osteoporosis aged 75 and older. J Am Geriatr Soc. 2010;58(2):292–299. https://doi.org/10.1111/j.1532-5415.2009.02673.x.Eriksen E.F., Lyles K.W., Colón-Emeric C.S., Pieper C.F., Magaziner J.S., Adachi J.D. et al. Antifracture efficacy and reduction of mortality in relation to timing of the first dose of zoledronic acid after hip fracture. J Bone Miner Res. 2009;24(7):1308–1313. https://doi.org/10.1359/jbmr.090209.Eriksen E.F., Lyles K.W., Colón-Emeric C.S., Pieper C.F., Magaziner J.S., Adachi J.D. et al. Antifracture efficacy and reduction of mortality in relation to timing of the first dose of zoledronic acid after hip fracture. J Bone Miner Res. 2009;24(7):1308–1313. https://doi.org/10.1359/jbmr.090209.Fu L.J., Tang T.T., Hao Y.Q., Dai K.R. Long-term effects of alendronate on fracture healing and bone remodeling of femoral shaft in ovariectomized rats. Acta Pharmacol Sin. 2013;34(3):387–392. https://doi.org/10.1038/aps.2012.170.Fu L.J., Tang T.T., Hao Y.Q., Dai K.R. Long-term effects of alendronate on fracture healing and bone remodeling of femoral shaft in ovariectomized rats. Acta Pharmacol Sin. 2013;34(3):387–392. https://doi.org/10.1038/aps.2012.170.Hauser M., Siegrist M., Keller I., Hofstetter W. Healing of fractures in osteoporotic bones in mice treated with bisphosphonates – A transcriptome analysis. Bone. 2018;112:107–119. https://doi.org/10.1016/j.bone.2018.04.017.Hauser M., Siegrist M., Keller I., Hofstetter W. Healing of fractures in osteoporotic bones in mice treated with bisphosphonates – A transcriptome analysis. Bone. 2018;112:107–119. https://doi.org/10.1016/j.bone.2018.04.017.He Y., Bao W., Wu X.D., Huang W., Chen H., Li Z. Effects of systemic or local administration of zoledronate on implant osseointegration: a preclinical meta-analysis. Biomed Res Int. 2019;2019:9541485. https://doi.org/10.1155/2019/9541485.He Y., Bao W., Wu X.D., Huang W., Chen H., Li Z. Effects of systemic or local administration of zoledronate on implant osseointegration: a preclinical meta-analysis. Biomed Res Int. 2019;2019:9541485. https://doi.org/10.1155/2019/9541485.Gao Y., Liu X., Gu Y., Song D., Ding M., Liao L. et al. The effect of bisphosphonates on fracture healing time and changes in bone mass density: a meta-analysis. Front Endocrinol (Lausanne). 2021;12:688269. https://doi.org/10.3389/fendo.2021.688269.Gao Y., Liu X., Gu Y., Song D., Ding M., Liao L. et al. The effect of bisphosphonates on fracture healing time and changes in bone mass density: a meta-analysis. Front Endocrinol (Lausanne). 2021;12:688269. https://doi.org/10.3389/fendo.2021.688269.Reid I.R., Horne A.M., Mihov B., Stewart A., Garratt E., Wong S. et al. Fracture prevention with zoledronate in older women with osteopenia. N Engl J Med. 2018;379(25):2407–2416. https://doi.org/10.1056/NEJMoa1808082.Reid I.R., Horne A.M., Mihov B., Stewart A., Garratt E., Wong S. et al. Fracture prevention with zoledronate in older women with osteopenia. N Engl J Med. 2018;379(25):2407–2416. https://doi.org/10.1056/NEJMoa1808082.McClung M., Miller P., Recknor C., Mesenbrink P., Bucci-Rechtweg C., Benhamou C.L. Zoledronic acid for the prevention of bone loss in postmenopausal women with low bone mass: a randomized controlled trial. Obstet Gynecol. 2009;114(5):999–1007. https://doi.org/10.1097/ AOG.0b013e3181bdce0a.McClung M., Miller P., Recknor C., Mesenbrink P., Bucci-Rechtweg C., Benhamou C.L. Zoledronic acid for the prevention of bone loss in postmenopausal women with low bone mass: a randomized controlled trial. Obstet Gynecol. 2009;114(5):999–1007. https://doi.org/10.1097/ AOG.0b013e3181bdce0a.Gennari L., Bilezikian J.P. New and developing pharmacotherapy for osteoporosis in men. Expert Opin Pharmacother. 2018;19(3):253–264. https://doi.org/10.1080/14656566.2018.1428559.Gennari L., Bilezikian J.P. New and developing pharmacotherapy for osteoporosis in men. Expert Opin Pharmacother. 2018;19(3):253–264. https://doi.org/10.1080/14656566.2018.1428559.Orwoll E.S., Miller P.D., Adachi J.D., Brown J., Adler R.A., Kendler D. et al. Efficacy and safety of a once-yearly i.v. Infusion of zoledronic acid 5 mg versus a once-weekly 70-mg oral alendronate in the treatment of male osteoporosis: a randomized, multicenter, double-blind, active-controlled study. J Bone Miner Res. 2010;25(10):2239–2250. https://doi.org/10.1002/jbmr.119.Orwoll E.S., Miller P.D., Adachi J.D., Brown J., Adler R.A., Kendler D. et al. Efficacy and safety of a once-yearly i.v. Infusion of zoledronic acid 5 mg versus a once-weekly 70-mg oral alendronate in the treatment of male osteoporosis: a randomized, multicenter, double-blind, active-controlled study. J Bone Miner Res. 2010;25(10):2239–2250. https://doi.org/10.1002/jbmr.119.Boonen S., Reginster J.Y., Kaufman J.M., Lippuner K., Zanchetta J., Langdahl B. et al. Fracture risk and zoledronic acid therapy in men with osteoporosis. N Engl J Med. 2012;367(18):1714–1723. https://doi.org/10.1056/NEJMoa1204061.Boonen S., Reginster J.Y., Kaufman J.M., Lippuner K., Zanchetta J., Langdahl B. et al. Fracture risk and zoledronic acid therapy in men with osteoporosis. N Engl J Med. 2012;367(18):1714–1723. https://doi.org/10.1056/NEJMoa1204061.Chiodini I., Merlotti D., Falchetti A., Gennari L. Treatment options for glucocorticoid-induced osteoporosis. Expert Opin Pharmacother. 2020;21(6):721–732. https://doi.org/10.1080/14656566.2020.1721467.Chiodini I., Merlotti D., Falchetti A., Gennari L. Treatment options for glucocorticoid-induced osteoporosis. Expert Opin Pharmacother. 2020;21(6):721–732. https://doi.org/10.1080/14656566.2020.1721467.Allen C.S., Yeung J.H., Vandermeer B., Homik J. Bisphosphonates for steroidinduced osteoporosis. Cochrane Database Syst Rev. 2016;10(10):CD001347. https://doi.org/10.1002/14651858.CD001347.pub2.Allen C.S., Yeung J.H., Vandermeer B., Homik J. Bisphosphonates for steroidinduced osteoporosis. Cochrane Database Syst Rev. 2016;10(10):CD001347. https://doi.org/10.1002/14651858.CD001347.pub2.Reid D.M., Devogelaer J.P., Saag K., Roux C., Lau C.S., Reginster J.Y. et al. Zoledronic acid and risedronate in the prevention and treatment of glucocorticoid-induced osteoporosis (HORIZON): a multicentre, doubleblind, double-dummy, randomised controlled trial. Lancet. 2009;373(9671):1253–1263. https://doi.org/10.1016/S0140-6736(09)60250-6.Reid D.M., Devogelaer J.P., Saag K., Roux C., Lau C.S., Reginster J.Y. et al. Zoledronic acid and risedronate in the prevention and treatment of glucocorticoid-induced osteoporosis (HORIZON): a multicentre, doubleblind, double-dummy, randomised controlled trial. Lancet. 2009;373(9671):1253–1263. https://doi.org/10.1016/S0140-6736(09)60250-6.Raterman H.G., Bultink I.E., Lems W.F. Osteoporosis in patients with rheumatoid arthritis: an update in epidemiology, pathogenesis, and fracture prevention. Expert Opin Pharmacother. 2020;21(14):1725–1737. https://doi.org/10.1080/14656566.2020.1787381.Raterman H.G., Bultink I.E., Lems W.F. Osteoporosis in patients with rheumatoid arthritis: an update in epidemiology, pathogenesis, and fracture prevention. Expert Opin Pharmacother. 2020;21(14):1725–1737. https://doi.org/10.1080/14656566.2020.1787381.Xie J., Li S., Xiao L., Ouyang G., Zheng L., Gu Y. et al. Zoledronic acid ameliorates the effects of secondary osteoporosis in rheumatoid arthritis patients. J Orthop Surg Res. 2019;14(1):421. https://doi.org/10.1186/s13018-019-1492-3.Xie J., Li S., Xiao L., Ouyang G., Zheng L., Gu Y. et al. Zoledronic acid ameliorates the effects of secondary osteoporosis in rheumatoid arthritis patients. J Orthop Surg Res. 2019;14(1):421. https://doi.org/10.1186/s13018-019-1492-3.Jarrett S.J., Conaghan P.G., Sloan V.S., Papanastasiou P., Ortmann C.E., O’Connor P.J. et al. Preliminary evidence for a structural benefit of the new bisphosphonate zoledronic acid in early rheumatoid arthritis. Arthritis Rheum. 2006;54(5):1410–1414. https://doi.org/10.1002/art.21824.Jarrett S.J., Conaghan P.G., Sloan V.S., Papanastasiou P., Ortmann C.E., O’Connor P.J. et al. Preliminary evidence for a structural benefit of the new bisphosphonate zoledronic acid in early rheumatoid arthritis. Arthritis Rheum. 2006;54(5):1410–1414. https://doi.org/10.1002/art.21824.Adami S., Giannini S., Bianchi G., Sinigaglia L., Di Munno O., Fiore C.E. et al. Vitamin D status and response to treatment in post-menopausal osteoporosis. Osteoporos Int. 2009;20(2):239–244. https://doi.org/10.1007/s00198-008-0650-у.Adami S., Giannini S., Bianchi G., Sinigaglia L., Di Munno O., Fiore C.E. et al. Vitamin D status and response to treatment in post-menopausal osteoporosis. Osteoporos Int. 2009;20(2):239–244. https://doi.org/10.1007/s00198-008-0650-у.Родионова С.С., Еловой-Вронский А.А., Бернакевич А.И. Альфакальцидол или холекальциферол в комбинации с ибандроновой кислотой при лечении постменопаузального системного остеопороза. Остеопороз и остеопатии. 2014;(1):21–24. https://doi.org/10.14341/osteo2014121-24. Rodionova S.S., Elovoy-Vronskiy A.A., Bernakevich A.I. Alfacalcidol or cholecalciferol in combination with ibandronic acid in the treatment of postmenopausal systemic osteoporosis. Osteoporosis and Bone Diseases. 2014;(1):21–24. (In Russ.) https://doi.org/10.14341/osteo2014121-24.Родионова С.С., Еловой-Вронский А.А., Бернакевич А.И. Альфакальцидол или холекальциферол в комбинации с ибандроновой кислотой при лечении постменопаузального системного остеопороза. Остеопороз и остеопатии. 2014;(1):21–24. https://doi.org/10.14341/osteo2014121-24. Rodionova S.S., Elovoy-Vronskiy A.A., Bernakevich A.I. Alfacalcidol or cholecalciferol in combination with ibandronic acid in the treatment of postmenopausal systemic osteoporosis. Osteoporosis and Bone Diseases. 2014;(1):21–24. (In Russ.) https://doi.org/10.14341/osteo2014121-24.Ozasa R., Saito M., Ishimoto T., Matsugaki A., Matsumoto Y., Nakano T. Combination treatment with ibandronate and eldecalcitol prevents osteoporotic bone loss and deterioration of bone quality characterized by nano-arrangement of the collagen/apatite in an ovariectomized aged rat model. Bone. 2022;157:116309. https://doi.org/10.1016/j.bone.2021.116309.Ozasa R., Saito M., Ishimoto T., Matsugaki A., Matsumoto Y., Nakano T. Combination treatment with ibandronate and eldecalcitol prevents osteoporotic bone loss and deterioration of bone quality characterized by nano-arrangement of the collagen/apatite in an ovariectomized aged rat model. Bone. 2022;157:116309. https://doi.org/10.1016/j.bone.2021.116309.Khajuria D.K., Razdan R., Mahapatra D.R. Zoledronic acid in combination with alfacalcidol has additive effects on trabecular microarchitecture and mechanical properties in osteopenic ovariectomized rats. J Orthop Sci. 2014;19(4):646–656. https://doi.org/10.1007/s00776-014-0557-8.Khajuria D.K., Razdan R., Mahapatra D.R. Zoledronic acid in combination with alfacalcidol has additive effects on trabecular microarchitecture and mechanical properties in osteopenic ovariectomized rats. J Orthop Sci. 2014;19(4):646–656. https://doi.org/10.1007/s00776-014-0557-8.Khajuria D.K., Disha C., Razdan R., Mahapatra D.R. Efeito combinado do ácido zoledrônico e do alfacalcidol no tratamento da osteoporose por desuso em ratos. Rev Bras Reumatol. 2015;55(3):240–250. https://doi.org/10.1016/j.rbr.2014.08.007.Khajuria D.K., Disha C., Razdan R., Mahapatra D.R. Efeito combinado do ácido zoledrônico e do alfacalcidol no tratamento da osteoporose por desuso em ratos. Rev Bras Reumatol. 2015;55(3):240–250. https://doi.org/10.1016/j.rbr.2014.08.007.Anastasilakis A.D., Papapoulos S.E., Polyzos S.A., Appelman-Dijkstra N.M., Makras P. Zoledronate for the prevention of bone loss in women discontinuing denosumab treatment. A prospective 2-year clinical trial. J Bone Miner Res. 2019;34(12):2220–2228. https://doi.org/10.1002/jbmr.3853.Anastasilakis A.D., Papapoulos S.E., Polyzos S.A., Appelman-Dijkstra N.M., Makras P. Zoledronate for the prevention of bone loss in women discontinuing denosumab treatment. A prospective 2-year clinical trial. J Bone Miner Res. 2019;34(12):2220–2228. https://doi.org/10.1002/jbmr.3853.Grassi G., Chiodini I., Palmieri S., Cairoli E., Arosio M., Eller-Vainicher C. Bisphosphonates after denosumab withdrawal reduce the vertebral fractures incidence. Eur J Endocrinol. 2021;185(3):387–396. https://doi.org/10.1530/EJE-21-0157.Grassi G., Chiodini I., Palmieri S., Cairoli E., Arosio M., Eller-Vainicher C. Bisphosphonates after denosumab withdrawal reduce the vertebral fractures incidence. Eur J Endocrinol. 2021;185(3):387–396. https://doi.org/10.1530/EJE-21-0157.Langdahl B. Treatment of postmenopausal osteoporosis with bone-forming and antiresorptive treatments: combined and sequential approaches. Bone. 2020;139:115516. https://doi.org/10.1016/j.bone.2020.115516.Langdahl B. Treatment of postmenopausal osteoporosis with bone-forming and antiresorptive treatments: combined and sequential approaches. Bone. 2020;139:115516. https://doi.org/10.1016/j.bone.2020.115516.Cosman F., Eriksen E.F., Recknor C., Miller P.D., Guañabens N., Kasperk C. et al. Effects of intravenous zoledronic acid plus subcutaneous teriparatide [rhPTH(1-34)] in postmenopausal osteoporosis. J Bone Miner Res. 2011;26(3):503–511. https://doi.org/10.1002/jbmr.238.Cosman F., Eriksen E.F., Recknor C., Miller P.D., Guañabens N., Kasperk C. et al. Effects of intravenous zoledronic acid plus subcutaneous teriparatide [rhPTH(1-34)] in postmenopausal osteoporosis. J Bone Miner Res. 2011;26(3):503–511. https://doi.org/10.1002/jbmr.238.You R., Liu J., Ke L., Yu G., Zhang Y., Mori T. Cost-Effectiveness of sequential teriparatide/zoledronic acid compared with zoledronic acid monotherapy for postmenopausal osteoporotic women in china. Front Public Health. 2022;10:794861. https://doi.org/10.3389/fpubh.2022.794861.You R., Liu J., Ke L., Yu G., Zhang Y., Mori T. Cost-Effectiveness of sequential teriparatide/zoledronic acid compared with zoledronic acid monotherapy for postmenopausal osteoporotic women in china. Front Public Health. 2022;10:794861. https://doi.org/10.3389/fpubh.2022.794861.Yeam C.T., Chia S., Tan H.C.C., Kwan Y.H., Fong W., Seng J.J.B. A systematic review of factors affecting medication adherence among patients with osteoporosis. Osteoporos Int. 2018;29(12):2623–2637. https://doi.org/10.1007/s00198-018-4759-3.Yeam C.T., Chia S., Tan H.C.C., Kwan Y.H., Fong W., Seng J.J.B. A systematic review of factors affecting medication adherence among patients with osteoporosis. Osteoporos Int. 2018;29(12):2623–2637. https://doi.org/10.1007/s00198-018-4759-3.Cooper A., Drake J., Brankin E. Treatment persistence with once-monthly ibandronate and patient support vs. once-weekly alendronate: results from the PERSIST study. Int J Clin Pract. 2006;60(8):896–905. https://doi.org/10.1111/j.1742-1241.2006.01059.x.Cooper A., Drake J., Brankin E. Treatment persistence with once-monthly ibandronate and patient support vs. once-weekly alendronate: results from the PERSIST study. Int J Clin Pract. 2006;60(8):896–905. https://doi.org/10.1111/j.1742-1241.2006.01059.x.Fobelo Lozano M.J., Sánchez-Fidalgo S. Adherence and preference of intravenous zoledronic acid for osteoporosis versus other bisphosphonates. Eur J Hosp Pharm. 2019;26(1):4–9. https://doi.org/10.1136/ejhpharm-2017-001258.Fobelo Lozano M.J., Sánchez-Fidalgo S. Adherence and preference of intravenous zoledronic acid for osteoporosis versus other bisphosphonates. Eur J Hosp Pharm. 2019;26(1):4–9. https://doi.org/10.1136/ejhpharm-2017-001258.Curtis J.R., Yun H., Matthews R., Saag K.G., Delzell E. Adherence with intravenous zoledronate and intravenous ibandronate in the United States Medicare population. Arthritis Care Res (Hoboken). 2012;64(7):1054–1060. https://doi.org/10.1002/acr.21638.Curtis J.R., Yun H., Matthews R., Saag K.G., Delzell E. Adherence with intravenous zoledronate and intravenous ibandronate in the United States Medicare population. Arthritis Care Res (Hoboken). 2012;64(7):1054–1060. https://doi.org/10.1002/acr.21638.Grey A., Horne A., Gamble G., Mihov B., Reid I.R., Bolland M. Ten years of very infrequent zoledronate therapy in older women: an open-label extension of a randomized trial. J Clin Endocrinol Metab. 2020;105(4):dgaa062. https://doi.org/10.1210/clinem/dgaa062.Grey A., Horne A., Gamble G., Mihov B., Reid I.R., Bolland M. Ten years of very infrequent zoledronate therapy in older women: an open-label extension of a randomized trial. J Clin Endocrinol Metab. 2020;105(4):dgaa062. https://doi.org/10.1210/clinem/dgaa062.Mori T., Crandall C.J., Fujii T., Ganz D.A. Cost-effectiveness of zoledronic acid compared with sequential denosumab/alendronate for older osteoporotic women in Japan. Arch Osteoporos. 2021;16(1):113. https://doi.org/10.1007/s11657-021-00956-z.Mori T., Crandall C.J., Fujii T., Ganz D.A. Cost-effectiveness of zoledronic acid compared with sequential denosumab/alendronate for older osteoporotic women in Japan. Arch Osteoporos. 2021;16(1):113. https://doi.org/10.1007/s11657-021-00956-z.Akehurst R., Brereton N., Ariely R., Lusa T., Groot M., Foss P., Boonen S. The cost effectiveness of zoledronic acid 5 mg for the management of postmenopausal osteoporosis in women with prior fractures: evidence from Finland, Norway and the Netherlands. J Med Econ. 2011;14(1):53–64. https://doi.org/10.3111/13696998.2010.545563.Akehurst R., Brereton N., Ariely R., Lusa T., Groot M., Foss P., Boonen S. The cost effectiveness of zoledronic acid 5 mg for the management of postmenopausal osteoporosis in women with prior fractures: evidence from Finland, Norway and the Netherlands. J Med Econ. 2011;14(1):53–64. https://doi.org/10.3111/13696998.2010.545563.You R., Zhang Y., Wu D.B., Liu J., Qian X., Luo N., Mori T. Cost-effectiveness of zoledronic acid versus oral alendronate for postmenopausal osteoporotic women in china. Front Pharmacol. 2020;11:456. https://doi.org/10.3389/fphar.2020.00456.You R., Zhang Y., Wu D.B., Liu J., Qian X., Luo N., Mori T. Cost-effectiveness of zoledronic acid versus oral alendronate for postmenopausal osteoporotic women in china. Front Pharmacol. 2020;11:456. https://doi.org/10.3389/fphar.2020.00456.Albert S.G., Reddy S. Clinical evaluation of cost efficacy of drugs for treatment of osteoporosis: a meta-analysis. Endocr Pract. 2017;23(7):841–856. https://doi.org/10.4158/EP161678.RA.Albert S.G., Reddy S. Clinical evaluation of cost efficacy of drugs for treatment of osteoporosis: a meta-analysis. Endocr Pract. 2017;23(7):841–856. https://doi.org/10.4158/EP161678.RA.

The authors declare that there are no conflicts of interest present.