Role of zoledronic acid in treatment of osteoporosis and prevention of fractures

Introduction. One of the causes of primary disability and high mortality, among patients with osteoporosis, are fractures that occur with minimal trauma, as a rule, it is a fall from the height of one’s own height. The final link in the chain of preventive measures to reduce the frequency of osteoporosis and fractures on its background is the introduction of pharmacological correction of bone deficiency into the practical activity of an orthopedic traumatologist. Currently, there are several drugs that can change the disturbed metabolism. For example, the use of zoledronic acid significantly reduces the risk of fractures.

Aim: to study the effect of zoledronic acid on bone mineral density in patients with osteoporosis complicated by a fracture of proximal end of the femur.

Materials and methods. In a prospective cohort study, 14 patients received zoledronic acid for 2 years.

Results. When comparing BMD L2-L4, it was revealed that a year after the start of treatment, its increase relative to the baseline value was 4.6%, but was statistically insignificant (0.86 ± 0.078 g/cm² versus 0.90 ± 0.08 g/cm², p > 0.05). After 2 years of treatment, the BMD of this segment increased, relative to the baseline values, by 12% and the differences became statistically significant (0.86 ± 0.078 g/cm² compared to 0.97 ± 0.076 g/cm², p < 0.05). The increase in BMD for the second year of treatment by 6% was statistically significantly different from the increase for the first year of treatment (0.90 ± 0.08 g/cm² compared to 0.97 ± 0.076 g/cm², p < 0.05).

A comparative analysis of the basic units of the IPC hip after 1 and 2 years of treatment did not reveal significant differences: 0.7075 ± 0.046 g/cm² compared to 0.7079 ± 0.034 g/cm² and 0.70751 ± 0.046 g/cm² compared to 0.6630 ± 0.97 g/cm², p > 0.05. In any case, for 2 years not marked new vertebral body fractures. Only one patient had a fracture of the radius in the distal third. The quality of life, after 2 years, significantly improved on the scale of “habitual daily activities” (p = 0.007), decreased indicators on the scale of “anxiety” and “depression” (p > 0.05).

Discussion. The study confirmed that even in the presence of pronounced bone loss, pharmacological correction of impaired remodeling reduces the risk of new fractures and improves the quality of life.

Conclusion. Pharmacotherapy with zoledronic acid, in our study, confirmed its effectiveness in the treatment of osteoporosis.

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