BoneKEy Reports | BoneKEy Watch
Longer-term osteoporosis treatment may be advantageous
DOI:10.1038/bonekey.2012.83
Postmenopausal women given intravenous treatment with 5 mg zoledronic acid (ZOL) once a year for three years show reduced fracture risk; an extension to the HORIZON-PFT trial has now investigated the impact of either discontinuing or continuing the same treatment for a further three years.
The study reveals that in the extension phase of the trial, women who continued ZOL treatment maintained bone mineral density (BMD) at the femoral neck and other sites, whereas women who moved onto placebo treatment showed a slight reduction in BMD, but this remained higher than before treatment. Few other clinically significant differences were observed in terms of bone turnover markers and adverse effects but the rate of new vertebral fractures was higher in subjects who discontinued therapy compared to those in the continuous ZOL group (odds ratio=0.51; P=0.035). The authors suggest that women with a high risk of vertebral fracture could help avoid such fractures by continuing annual treatment with ZOL.
Editor's comment: These data from a large cohort support NOT recommending a drug holiday from bisphosphonates for patients at high risk of vertebral fracture. The results also suggest that neither bone density nor bone turnover markers are useful for assessing spine fracture risk in patients who discontinue zoledronic acid treatment.
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