BoneKEy Reports | BoneKEy Watch
The 5-year impact of a single dose of zoledronate
DOI:10.1038/bonekey.2012.123
The long-term impact of a single injection of zoledronate (ZOL) has been studied in 50 postmenopausal women, who were given 5 mg ZOL or placebo and then monitored for 3 years. Grey et al. have now extended this study, providing no further treatment but maintaining blinding while following the women for another two years.
Markers of bone turnover, ß-C-terminal telopeptide of type I collagen (ß-CTX) and procollagen type-I N-terminal propeptide (P1NP) were assessed at baseline, 3 months, 12 months and then every 6 months up to the 5 year time point.
Mean levels of both markers were 40–50% lower in women in the ZOL group compared with those in the control group at all time points (P<0.0001). At 5 years, a mean reduction of 48% was observed for ß-CTX, with P1NP levels 45% lower. Bone mineral density (BMD) was 4–5% higher in the ZOL group at all time points (P<0.0001 for lumbar spine, total hip and total body BMD).
Editor's comment: It is not yet clear whether this sustained (permanent?) effect of a single dose of ZOL results in long-term reduction in fracture risk and so could justify longer intervals between doses. How a single small dose of a bisphosphonate with a very high affinity for bone may exert such a prolonged effect on bone turnover is also not understood.
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