Bisphosphonates in the treatment of osteoporosis (continuation)

In 2020, Wen F, Du H, Ding L, Hu J, Huang Z et al., PLoS ONE have synthesized current evidence from recently published randomized clinical trials, including two new approved agents (romososumab and abaloparatide) and a new method of drug administration, in particular the introduction of zoledronate at a dose of 5 mg once every 18 months. The analysis included 57 studies, 24692 women in the primary prevention group and 76678 women in the secondary prevention group, whose average age was 67.5 years, and drugs such as abaloparatide, alendronate, bazedoxifene, denosumab, ibandronate, lasofoxifene, parathyroid hormone, raloxifene, risedronate, romososumab, strontium ranelate, teriparatide and zoledronate. The intravenously introduction of zoledronate at the doses of 5 mg once every 12 months, 5 mg i.v. once every 18 months, and 5 mg i.v. once every 24 months was analysed separately. This ensured the undoubted accuracy of the results.

The purpose of this meta-analysis was to assess the comparative efficacy and safety of drugs used for primary and secondary prevention of osteoporotic fractures in postmenopausal women, and, accordingly, to determine the optimal intervention for primary and secondary prevention based on considering both the efficacy and safety of the therapy. As a result, the following important conclusions were drawn for each of the groups:

• ü zoledronate, used at a dose of 5 mg once every 18 months, has comparable safety with placebo, while it is the only drug that has been shown to significantly reduce both vertebral and non-vertebral fractures in the primary prevention of osteoporotic fractures in postmenopausal women.
• ü for secondary prevention, abaloparatide, alendronate, denosumab, lasofoxifene, risedronate, romososumab, teriparatide, and zoledronate (5 mg i.v. once every 12 months) reduced both vertebral (RR: 0.17 to 0.62) and non-vertebral fractures ( HRs: 0.54 to 0.81).

In Ukraine only Ananta Medicare has a generic zoledronic acid in its range. The medicinal product named Zoleum (zoledronic acid of 5 mg per 100 ml) is available for patients with osteoporosis.

ZOLEUM. Convenient management of osteoporosis!