Comparison of two different strategies of treatment with zoledronate in HIV‐infected patients with low bone mineral density: single dose versus two doses in 2 years

• Published in: HIV medicine 2015-08, Vol.16 (7), p.441-448
• Main Authors: Negredo, E, Bonjoch, A, Pérez‐Álvarez, N, Ornelas, A, Puig, J, Herrero, C, Estany, C, Río, L, Gregorio, S, Echeverría, P, Clotet, B
• Format: Article
• Language: English
• Subjects: Absorptiometry, Photon; annual administration; Antiretroviral Therapy, Highly Active - adverse effects; biennial administration; Biomarkers - blood; bisphosphonate; Bone Density - drug effects; Bone Density Conservation Agents - administration & dosage; bone mineral density; Bone Remodeling - drug effects; Diphosphonates - administration & dosage; Directive Counseling; Dose-Response Relationship, Drug; Drug Administration Schedule; dual‐energy X‐ray absorptiometry scan; Feeding Behavior; Female; HIV; HIV Infections - drug therapy; Humans; Imidazoles - administration & dosage; Lumbar Vertebrae - metabolism; Male; Middle Aged; osteoporosis; Osteoporosis - chemically induced; Osteoporosis - physiopathology; Osteoporosis - therapy; Pelvic Bones - metabolism; Pilot Projects; Treatment Outcome; zoledronate
• ISSN: 1464-2662; 1468-1293
• DOI: 10.1111/hiv.12260

Objectives Given the need for easily managed treatment of osteoporosis in HIV‐infected patients, we evaluated the efficacy and tolerability of two doses of zoledronate, by comparing three groups of patients: those with annual administration, those with biennial administration (one dose in 2 years) and a control group with no administration of zoledronate. Methods We randomized (2:1) 31 patients on antiretroviral therapy with low bone mineral density (BMD) to zoledronate (5 mg administered intravenously; 21 patients) plus diet counselling and to a control group (diet counselling; 10 patients). At week 48, patients treated with zoledronate were randomized again to receive a second dose (two‐dose group; n = 12) or to continue with diet counselling only (single‐dose group; n = 9). Changes in lumbar spine and hip BMD and bone turnover markers were compared. Results The median percentage change from baseline to week 96 in L1−L4 BMD was −1.74% [interquartile range (IQR) −2.56, 3.60%], 7.90% (IQR 4.20, 16.57%) and 5.22% (IQR 2.02, 7.28%) in the control, two‐dose and single‐dose groups, respectively (P