Clinical efficacy and safety of zoledronic acid in combination with PVP/PKP in the treatment of osteoporotic vertebral compression fractures

Osteoporosis is a metabolic disease of the skeletal system characterized by low bone density, systemic skeletal pain and a tendency to fracture bones. Osteoporotic vertebral compression fractures (OVCF) is one of the most common complications of osteoporosis and a public health emergency in elderly population. OVCF affects millions of people worldwide, and has an incidence of 11-50% in the elderly. Patients with OVCF may experience severe low back pain with limited mobility, severe kyphosis with a long course and frequent relapses. Thus, OVCF affects the physical and mental health, reduces the quality and life expectancy of patients. In 2021, a team of authors Yan Sun, Haoning Ma et al., published a meta-analysis in BioMed Research International. The purpose of the meta-analysis was to obtain more reliable evidence for the efficacy and safety of the combined use of zoledronic acid (ZA) with percutaneous vertebroplasty / kyphoplasty (PVP / PKP) in osteoporotic vertebral compression fracture (OVCF). The meta-analysis includes all randomized controlled trials (RCTs) of zoledronic acid in combination with PVP or PKP compared with PVP/PKP alone for the treatment of patients with OVCF. As a result, 7 RCTs were selected with a total of 929 patients. Following the procedure and the introduction of zoledronic acid, the one year evaluation was performed. The meta-analysis has shown that the additional administration of zoledronic acid 5 mg/100 ml in the perioperative period demonstrates some advantages, such as a more pronounced analgesic effect and an improvement in bone metabolism compared with PVP/PKP alone. In addition, the combination therapy significantly prevented complications in the form of repeated fractures, while the drug therapy was well tolerated. Overall, this systematic review has shown that zoledronic acid in combination with PVP/PKP is an effective, safe and comprehensive therapy for patients with osteoporotic vertebral compression fracture.

Source: Yan Sun, Haoning Ma et al., Clinical Efficacy and Safety of Zoledronic Acid Combined with PVP/PKP in the Treatment of Osteoporotic Vertebral Compression Fracture: A Systematic Review and Meta-Analysis of Randomized Controlled Trials, BioMed Research International, 2021