Factors associated with acute-phase response of bisphosphonate-naïve or pretreated women with osteoporosis receiving an intravenous first dose of zoledronate or ibandronate

• Published in: Osteoporosis international 2017-06, Vol.28 (6), p.1995-2002
• Main Authors: Popp, A.W., Senn, R., Curkovic, I., Senn, C., Buffat, H., Popp, P.F., Lippuner, K.
• Format: Article
• Language: English
• Subjects: Acute-Phase Reaction - chemically induced; Aged; Arthralgia; Bisphosphonates; Bone Density Conservation Agents - administration & dosage; Bone Density Conservation Agents - adverse effects; Bone Density Conservation Agents - therapeutic use; Clinical trials; Diphosphonates - administration & dosage; Diphosphonates - adverse effects; Diphosphonates - therapeutic use; Endocrinology; Female; Humans; Ibandronic acid; Imidazoles - administration & dosage; Imidazoles - adverse effects; Imidazoles - therapeutic use; Infusions, Intravenous; Intravenous administration; Medicine; Medicine & Public Health; Middle Aged; Myalgia; Original Article; Orthopedics; Osteoporosis; Osteoporosis, Postmenopausal - drug therapy; Post-menopause; Prospective Studies; Rheumatology; Risk Factors; Severity of Illness Index; Vitamin D; Zoledronic acid
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-017-3992-5

Summary A first intravenous dose of bisphosphonates may be associated with an acute-phase response (APR). In bisphosphonate-naïve women with postmenopausal osteoporosis, the characteristics and frequency of APR may differ by compound. Prior bisphosphonate exposure was predictive of APR risk and severity. Introduction Intravenous (IV) administration of bisphosphonates (BP), such as zoledronate (ZOL) and ibandronate (IBN), may be associated with an APR. The characteristics of APR may differ by compound. The aim of the present study was to evaluate the characteristics of APR (rates, signs and symptoms, severity), in the absence of any preventive measure, after a first IV application of ZOL or IBN in patients naïve or previously exposed to BP in a real-world clinical setting. Methods This is an open-label prospective exploratory study with two cohorts of consecutive postmenopausal women with osteoporosis treated with either IV ZOL or IBN at the Department of Osteoporosis of the University Hospital of Berne, Switzerland. Results Intravenous BP was administered to 725 women (411 ZOL and 314 IBN). Prior oral or IV BP use was less frequent in the ZOL group (61.8 vs. 71.7%, p  = 0.005). In total, 301 women (41.5%) reported the presence of one or more signs or symptoms of APR with rates for ZOL and IBN of 47.7 and 33.4%, respectively ( p