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Zoledronic acid

Zoledronate (Zometa®, Novartis) is a bisphosphonate, used to prevent osteoporosis and skeletal fractures, particularly in patients with cancers such as multiple myeloma and prostate cancer. It can also be used to treat hypercalcemia, particularly hypercalcemia of malignancy. It can also be helpful for treating pain from bone metastases. more...

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Administration

Usually 4 mg intravenously once a month when given for oncologic purposes. It is given once a year for treatment of osteoporosis.

Side effects

Side effects can include fatigue, anemia, muscle aches, fevers, and swelling in the feet or legs. Zoledronate can cause deterioration in renal function.

A rare complicaiton of zoledronate is osteonecrosis of the jaw. This has mainly been seen in patients with multiple myeloma treated with zoledronate (Durie et al 2005).

Contraindications

  • Poor renal function (e.g. creatinine>3 mg/dL)
  • Pregnancy

Reference

  • Durie BG, Katz M, Crowley J. Osteonecrosis of the jaw and bisphosphonates. N Engl J Med 2005;353:99-102. PMID 16000365.

Read more at Wikipedia.org


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Abstract 3054: Cancer Patients With Bone Complications Overwhelmingly Prefer Infusion of Zoledronic Acid Over Pamidronate
From Market Wire,

A new study shows that patients strongly prefer zoledronic acid to pamidronate for the treatment of bone metastases that stem from various different cancer types. In the study, 89% of patients specifically mentioned the convenient 15-minute infusion time of zoledronic acid, compared with the 2 hours needed to administer pamidronate. The study was presented on May 31, 2003 at the American Society of Clinical Oncology (ASCO) meeting in Chicago, Illinois, USA.

"Meeting the needs of cancer patients is a top priority for oncologists. These data clearly show that patients prefer the more convenient 15-minute infusion of zoledronic acid to treat the serious and potentially life-threatening bone complications that result from their cancer," said Dr. Boris Chern, MBBS, FRACP, FRAChPM, District Director of Medical Oncology and Palliative Care, Redcliffe-Caboolture Health Service District, Queensland, Australia. "These results are extremely valuable in helping doctors determine the best treatment for their patients, not only in terms of efficacy, but also in terms of the patients' quality of life."

Study Details

Researchers enrolled 184 patients with bone metastases from prostate, breast, multiple myeloma and other solid tumors in a multi-centre study of preference for infusions of zoledronic acid (4 mg over 15 minutes) or pamidronate (90 mg over 2-4 hours). All patients received an initial infusion of zoledronic acid, to avoid confounding by flu-like symptoms that may occur with the first bisphosphonate infusion. For the next two infusions, patients were randomized to receive zoledronic acid then pamidronate or pamidronate then zoledronic acid, at 3-4 week intervals. 78% (144) completed a questionnaire regarding their preferences. Although this study did not assess the efficacy of the treatments used, pamidronate has not been shown to demonstrate efficacy in the treatment of bone metastases in prostate cancer and other solid tumors.

Of the 144 (78%) patients who completed the questionnaire designed to find out their preferences, 128 (89%) declared a preference for zoledronic acid. Of these patients, 53% cited less time needed for the infusion (15 minutes vs. two to four hours, respectively) and 33% cited less disruption to their day as the most important reasons for their preference.

Additionally, a subset of 14 patients later received zoledronic acid infusions at home and completed a second questionnaire on their preference for infusion location -- at home or in the clinic. Of these patients, 13 out of 14 preferred the home location, however, mentioned the lack of opportunity to talk with other patients.

"As a cancer patient, I deal with so many doctor visits, tests and treatment appointments, which leaves only little time for my family and other things I value in my life. A 15-minute infusion time versus two hours makes a world of difference to me," said Chern patient Rosemary Tindell.

About Redcliffe- Caboolture Health Service District

The Redcliffe-Caboolture Health Service District is located approximately 35 minutes north of Queensland's capital city, Brisbane, and is one of 39 health service districts in Queensland. The District's major facilities include three acute hospitals (Redcliffe, Caboolture and Kilcoy), two community health centres, mental health and oral health facilities and an aged care residential facility. The District provides primary and secondary health care services and employs 2068 staff members.

Dr Boris Chern is the District Director of Oncology and Palliative Care Services. Inpatient and outpatient oncology and palliative care services are provided at Redcliffe Hospital, with outpatient and community-based services provided at Caboolture and Kilcoy.

Contact: Sheilagh Marshall Company: Redcliffe-Caboolture Health Service District Title: District Community Liaison Officer Voice: + 011 61 7 3883 7768< br/> Email: Sheilagh_Marshall@health.qld.gov.au

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