Bone Abstracts

Introduction: We aimed to study acceptability of zoledronic acid in the treatment of postmenopausal osteoporosis within 3 years.

Methods: Clinical, biochemical, shipping registration at poll by phone and on the subsequent visits.

Results: We studied 225 patients with postmenopausal osteoporosis. The patients were treated with zoledronic acid (Zol) 5 mg as a once-yearly infusion within 3 years and 2500 mg of calcium carbonate+800 ME vitamin D₃ daily. 110 (48.9%) patients received paracetamol (1000 mg – three times a day, 3 days) for prevention of side effects on the day of the first infusion and the next 2 days. We found out that symptoms of acute phase response (SAPR) developed within 12–24 h after the infusion of Zol. SAPR were observed in 39% (n=43) of patients, who received paracetamol as prevention. Among those patients without treatment with paracetamol, SAPR developed at the rate of 65.3% (n=75) (OR=0.34 95% CI (0.2–0.59)). After the 2nd infusion symptoms of SAPR were reported in 27.9% (n=26) (P<0.05) out of 93 patients, after the 3rd in 6.6% (n=2) out of 30 patients. Symptoms of light (77.3%, n=58) and moderate severity (16%, n=12), and up to 3 day duration (68%, n=51) were observed after the 1st infusion. Bone and muscular manifestations and a flu-like syndrome were the most frequent symptoms (P<0.05).

Conclusions: Symptoms of acute phase response developed within the first 12–24 h after the infusion of zoledronic acid. SAPR were effectively prevented and treated with paracetamol. The reduction of quantity, severity and duration of SAPR was observed after each subsequent infusion.