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Zometa

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.

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Zoledronic acid: Annual IV may equal daily oral Tx for osteoporosis - Gyneology
From OB/GYN News, 4/15/02 by Michele G. Sullivan

Intermittent infusions of the biophosphate zoledronic acid in postmenopausal women--with dosages as far apart as 12 months--increase bone density and decrease markers of bone resorption as effectively as daily oral biophosphate therapy without significant side effects, Dr. Ian R. Reid of the University of Auckland, New Zealand, and his colleagues reported.

The 1-year, randomized, placebo-controlled study of 351 women with mild bone density loss, defined as a T score of less than -2, suggested that an annual infusion of the drug could control osteoporosis and eliminate the adverse effects of oral therapy that often decrease patient compliance, the investigators said (N. Engl. J. Med. 346[9]:653-61, 2002).

Novartis, which markets zoledronic acid as Zometa for the treatment of cancer-related bone metastases, designed and funded the study managed the data, and performed the statistical analysis.

The women received one of six treatment regimens during the study: zoledronic acid infusions every 3 months at dosages of 0.25 mg, 0.05 mg, or 1 mg; a 2-mg infusion every 6 months; a single 4-mg infusion; or a saline placebo.

At 12 months, bone mineral density at the spine in all the active treatment groups was 4.3%-5.1% higher than in the control group; bone mineral density at the femoral neck was 3.1%-3.5% higher than in the control group.

In the active treatment groups, bone resorption markers reached a nadir at 1 month and remained suppressed for the entire study, even with the single-dosage regimen. The control group had no significant marker changes.

Five nonvertebral fractures occurred in the active treatment groups, but the investigators said that a larger study would be necessary to determine the long-term effects of infusion therapy on fractures. Up to 67 percent of the active groups reported mild nausea, myalgia, and fever, most often after the first dosage.

COPYRIGHT 2002 International Medical News Group
COPYRIGHT 2002 Gale Group

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