BoneKEy Reports | BoneKEy Watch

Zoledronic acid prevents vertebral fractures in men with osteoporosis

DOI:10.1038/bonekey.2013.28

Here, Boonen et al. describe a multicenter, randomized controlled trial involving a placebo and double blinding, which followed 1100 men with osteoporosis given either a placebo or an intravenous injection of 5 mg zoledronic acid. Participants were aged 50–85 years and were included if they had one to three, mild to moderate, prevalent vertebral fractures and a bone mineral density (BMD) T score of −1.5 or less at the femoral neck of total hip. Men without fractures were also eligible if they had a BMD T score of −2.5 or less at the total hip, lumbar spine or femoral neck. Two doses were administered, one at baseline and the second 12 months later, with follow-up continuing for 24 months. All patients received calcium and vitamin D supplements.

At the 24-month point, significantly fewer patients treated with zoledronic acid had experienced new morphometric vertebral fractures compared to those in the placebo group (1.6 vs 4.9%; risk reduction 67%). Patients given zoledronic acid were also less likely to sustain moderate-to-severe vertebral fractures or to lose height, and showed higher bone mineral density and reduced levels of bone turnover markers. Both groups had similar death rates, and the incidence of serious adverse events was virtually identical.

Editor’s comment: This study confirms that yet another bisphosphonate is effective in treating male osteoporosis, this time producing direct evidence of a significant reduction of vertebral fractures, an effect that has already been demonstrated in osteoporotic women. It should reassure clinicians that zoledronic acid can be used successfully in men with primary or hypogonadism-associated osteoporosis.

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.