Zoledronic Acid Treatment of Osteoporosis: Effects in Men.

Author(s): Johnson DA, Williams MI, Petkov VI, Adler RA

Affiliation(s): Division of Endocrinology and Metabolism, Department of Internal Medicine, Virginia Commonwealth University School of Medicine.

Publication date & source: 2010-05-24, Endocr Pract., :1-23 [Epub ahead of print]

Objective There are few published studies of zoledronic acid treatment of osteoporosis in men. We studied changes in bone mineral density (BMD) and a bone resorption marker in 50 male veterans who received off-label zoledronic acid for osteoporosis treatment. Our purpose was to study this therapy in a "real world" setting with patients who might not qualify for a randomized controlled trial.Methods We conducted a retrospective chart review of male veterans who received at least one 4 mg intravenous infusion of zoledronic acid and had BMD at two of three sites both prior to the infusion and at a mean of 2.2 years after the infusion. Patients were divided into those who were bisphosphonate naive versus those who had previously been exposed to bisphosphonate.Results In our population, 66% of patients had been prescribed oral bisphosphonates or intravenous pamidronate before receiving zoledronic acid. Larger increases in spine (6.7% v. 3.4%, p<0.05; per year: 2.8% v. 1.2%, p<0.01) and total hip BMD (3.2% v. 0.1%, p<0.03; per year: 1.3% v. 0.02%, p<0.02) occurred in bisphosphonate naive patients compared with bisphosphonate exposed patients. Conclusions Our data suggest that 4 mg of intravenous zoledronic acid is an effective treatment for increasing BMD in a "real world" population of men with osteoporosis. The changes seen in BMD over a mean of two years were similar to those reported in clinical studies with alendronate in men and zoledronic acid in women.