Multicenter Study on Observation of Acute-phase Responses After Infusion of Zoledronic Acid 5mg in Chinese Women with Postmenopausal Osteoporosis

• Published in: Orthopaedic surgery Vol. 9; no. 3; p. 284
• Main Authors: Ding, Yue, Zeng, Jian-Cheng, Yin, Fei, Zhang, Chun-lin, Zhang, Yan, Li, Shi-xun, Liu, Xun, Zhang, Chao, Xue, Qing-yun, Lin, Hua, Pei, Fu-xing
• Format: Journal Article
• Language: English
• Published: Beijing John Wiley & Sons, Inc 01.08.2017
• Subjects: Acids; Osteoporosis; Pain
• ISSN: 1757-7853; 1757-7861
• DOI: 10.1111/os.12338

Objective It has been reported that acute-phase reactions (APR) after infusion of 5mg zoledronic acid for the first time is common. This study surveyed the incidence and characteristics of APR in Chinese postmenopausal women receiving 5mg zoledronic acid intravenously for osteoporosis and to evaluate the efficacy of non-steroidal anti-inflammatory drugs (NSAID) in preventing or alleviating APR following the first 5mg zoledronic acid infusion. Methods A total of 2601 patients with an average age of 68.14 ± 9.89years and a mean body mass index of 22.90 ± 3.24kg/m2 from 62 centers in China were treated with 5mg zoledronic acid intravenously for the first time. The incidence of fever and pain were observed in these patients, and the time of fever or pain onset and duration, and the intensity of fever and grade of pain were also recorded. The dosage, duration, and efficacy of NSAID and safety outcomes were also documented. Results At the end of the study, 18 patients are eliminated due to incomplete records of temperature. The incidence of fever was 28.65% (740/2583) within 7days following zoledronic acid infusion; 98.34% (727/740) occurred at 1.03 ± 0.66days after infusion and lasted 1.72 ± 0.93days. A total of 456 (17.53%) patients had newly onset pain (312 of 1187, 26.28%) or experienced pain aggravation (144 of 1414, 10.18%), which mostly occurred within 3days after zoledronic acid infusion. A total of 1246 (47.6%) patients had received NSAID for a median time of 2.63 ± 2.45days. Using NSAID for at least 2days could decrease body temperature by 0.54 ± 0.86°C, increase the percentage of pain-free patients by 6.17%, and reduce the percentage of patients with moderate to severe pain by 8.7%. Conclusions Compared with Western populations, Chinese patients had a higher rate of fever and pain after their first zoledronic acid infusion. These symptoms were often mild to moderate in intensity and transient in duration. NSAID could effectively reduce the incidence and severity of such APR.