Therapeutic efficacy of Zoledronic acid in combination with Calcitriol for treating senile Osteoporosis

<h2 id="Background">Background</h2><ul><li>Osteoporosis is a common metabolic bone disease marked by reduced bone mass, fragile microstructure, and high fracture risk, especially in the elderly.</li><li>Calcium and calcitriol help restore mineral balance, they are often insufficient alone.</li><li>Zoledronic acid, a third-generation bisphosphonate, inhibits osteoclast activity by targeting farnesyl pyrophosphate, thus reducing bone resorption and enhancing bone metabolism.</li><li>Clinically, it helps minimize bone loss, prevent fractures, relieve pain, and improve quality of life in osteoporosis patients.</li></ul><h2 id="Objective">Objective</h2><p>To evaluate the effectiveness and safety of zoledronic acid in combination with calcium and calcitriol for treating primary osteoporosis in elderly patients.</p><h2 id="Methods">Methods</h2><p><strong>78 elderly patients were randomized into two groups:</strong></p><ul><li><strong>CC Group (39):</strong> Calcium carbonate D3 (0.6 g once daily)+ Calcitriol (0.25 µgtwice daily).</li><li><strong>CCZ Group(39): </strong>Calcium carbonate D3 (0.6 g once daily)+ Calcitriol (0.25 µg twice daily)+ Zoledronic acid (5 mg IV once yearly (infused over 2:30 min).</li></ul><p><strong>Treatment duration:</strong> 1 year. <strong>Outcomes measured:</strong> Bone Mineral Density (BMD), bone metabolism markers, Qol (Quality of Life-QUALEFFO-41 scale), clinical efficacy, and adverse reactions (ARs).</p><h2 id="Results">Results</h2><ul><li>CCZ group showed increased BMD in the lumbar spine (Ll ~L4 segments), femoral neck, and hip after treatment relative to CCgroup. (Fig.1).</li></ul><p style="text-align:center;"><img src="https://cdn.megawecare.com/GHBY/Internal-Images/Comparison_of_BMD_in_Different_Parts.webp" alt="Comparison of BMD in different parts." width="876" height="413"></p><ul><li>Serum levels of bone-specific alkaline phosphatase(B-ALP), cross-linked type 1 collagen (-terminal peptide (CTX-1), and N-terminal propeptide of type 1 procollagen (PINP)decreased, while osteocalcin levels increased. (Fig.2)</li></ul><p style="text-align:center;"><img src="https://cdn.megawecare.com/GHBY/Internal-Images/Comparison_of_Different_bone_metabolism_indicators.webp" alt="Comparison of different bone metabolism indicators." width="876" height="322"></p><ul><li>The Qol Questionnaire of the European Foundation for Osteoporosis scores decreased (P &lt; 0.05 for all comparisons). (Fig.3).</li></ul><p style="text-align:center;"><img src="https://cdn.megawecare.com/GHBY/Internal-Images/Comparison_of_scores_for_various_Dimension_of_QUALEFFO.webp" alt="Comparison of scores for various dimensions of QUALEFF0-41. *P &lt; 0.05 vs. CC group" width="706" height="329"></p><ul><li>The clinical effectiveness rate was higher in the CCZ group compared to the CC group. Additionally, the adverse reaction (AR) rate was lower in the CCZ group than in the CC group.(Table 1).</li></ul><p style="text-align:center;"><img src="https://cdn.megawecare.com/GHBY/Internal-Images/Comparison_of_clinical_effective_and_adverse_reaction_rates_between_CCZ_and_CC_Group.webp" alt="Comparison of Clinical Effectiveness and Adverse Reaction Rates Between CCZ and CC Groups" width="876" height="130"></p><h2 id="Conclusion">Conclusion</h2><p>In elderly patients with primary osteoporosis, combination therapy using calcium carbonate with vitamin D3, calcitriol, and zoledronic acid shows superior clinical efficacy. It significantly improves bone density, enhances bone metabolism, boosts quality of life, and ensures a high level of medication safety.</p>

Opthal Update   Issue 4   2025

<ul><li><a href="#Background">Background</a></li><li><a href="#Objective">Objective</a></li><li><a href="#Methods">Methods</a></li><li><a href="#Results">Results</a></li><li><a href="#Conclusion">Conclusion</a></li></ul>

Therapeutic efficacy of Zoledronic acid in combination with Calcitriol for treating senile Osteoporosis

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