ObjectiveTo investigate the influence of zoledronic acid injection on body temperature of patients with primary osteoporosis. MethodsA total of 142 patients with primary osteoporosis who received intravenous zoledronic acid treatment in Peking university people’s hospital during 2013-2014 were enrolled in this study. The body temperature before and after intravenous zoledronic acid treatment were recorded and analyzed with SPSS 17.0 software. ResultsThe patients' body temperature at different time points after intravenous zoledronic acid treatment was significantly different (P=0.000). Prophylactic use of NSAIDs could significantly reduce patients' body temperature at the second day after intravenous zoledronic acid. ConclusionNSAIDs can be given orally on the same day of intravenous injection of zoledronic acid, and continued for three days.
Key words:
Zoledronic acid injection
;
Body temperature
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Prophylactic use
Importance of the field: Both bone metastases and fragility fractures due to bone loss result in considerable morbidity affecting quality of life and independence as well as placing complex demands on healthcare resources. Zoledronic acid is a widely used intravenous bisphosphonate that reduces this skeletal morbidity in both benign and malignant conditions.<br/>Area covered in this review: The incidence, clinical importance and prevention strategies to minimize side effects associated with the use of zoledronic acid are discussed with a particular focus on use in oncology where intensive monthly scheduling is required. This potentially increases the risk for adverse events over the 6 - 12 monthly administration used to treat benign bone diseases.<br/>What the reader will gain: A detailed understanding of the generally favorable safety profile of zoledronic acid, but particularly the potential for renal dysfunction and osteonecrosis of the jaw.<br/>Take home message: When compared to many other therapies, especially in the cancer setting, the severity of adverse events related to zoledronic acid is generally mild and, with the exception of the acute phase response causing transient fever, myalgia and bone pain, side effects are infrequent. Thus, the benefits of treatment with zoledronic acid within its licensed indications almost always outweigh the risks.
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REID IR,GAMBLE GD,MESENBRINKP,et al.Characterization of and risk factors for the acute-phase response after zoledronic acid[J].,2010,95( 9) : 4380-4387.
ABSTRACT Intravenous aminobisphosphonates often cause an acute-phase response (APR), but the precise components of this, its frequency, and the risk factors for its development have not been systematically studied. The objective of the study was to characterize the APR and determine its frequency and the risk factors for its development. The study was an analysis of adverse events from a large randomized trial. This was a multicenter international trial. Patients included 7765 postmenopausal women with osteoporosis. Zoledronic acid 5 mg annually or placebo was the intervention. Adverse events occurring within 3 d of zoledronic acid infusion were measured. More than 30 adverse events were significantly more common in the zoledronic acid group and were regarded collectively as constituting an APR. These were clustered into five groups: fever; musculoskeletal (pain and joint swelling); gastrointestinal (abdominal pain, vomiting, diarrhea); eye inflammation; and general (including fatigue, nasopharyngitis, edema). A total of 42.4% of the zoledronic acid group had an APR after the first infusion, compared with 11.7% of the placebo group. All APR components had their peak onset within 1 d, the median duration of the APR was 3 d, and severity was rated as mild or moderate in 90%. Stepwise regression showed that APR was more common in non-Japanese Asians, younger subjects, and nonsteroidal antiinflammatory drug users and was less common in smokers, patients with diabetes, previous users of oral bisphosphonates, and Latin Americans (P < 0.05 for all). This analysis identifies new components of the APR and provides the first assessment of risk factors for it. Despite its frequency, APR rarely resulted in treatment discontinuation in this study.
BERTOLDOF,PANCHERIS,ZENARIS,et al.Serum 25-hydroxyvitamin D levels modulate the acute-phase response associated with the first nitrogen-containing bisphosphonate infusion[J]. ,2010,25(3) : 447-454.
The acute-phase response (APR) is the most frequent side effect after the first dose of intravenous nitrogen-containing bisphosphonates (N-BPs). It has been demonstrated in vitro that N-BPs stimulate γδ T-cell proliferation and production of cytokines and that vitamin D is able to modulate them. Therefore, we have studied the relationship between bone metabolism parameters, particularly for 25-...
MAKRASP,ANASTASILAKIS AD,POLYZOS SA,et al.No effect of rosuvastatin in the zoledronate-induced acute phase response[J].,2011,88(5): 402-408.
The acute-phase response (APR) is frequently observed in patients treated with intravenous (iv) zoledronate (ZOL). We investigated whether a short course of rosuvastatin (ROSU) could attenuate the ZOL-induced APR through blocking the mevalonate pathway at a proximal level. Twenty-eight osteoporotic postmenopausal women with no prior bisphosphonate use (mean age 65.302±021.902years) were subjected to ZOL iv infusion. Patients were randomly assigned into either a ROSU+ group ( n 02=0212), which received ROSU 1002mg/day starting 502days before the infusion of ZOL for a total period of 1102days, or a ROSU61 group ( n 02=0216), which did not receive ROSU. The visual analog pain scale (VAS) for musculoskeletal symptoms and body temperature was used to define clinically APR. In addition, white blood cell (WBC) count, leukocytic subpopulations, and C-reactive protein (CRP) were obtained before and 4802h following the infusion. Seven (58.3%) patients in the ROSU+ group and 13 (81.3%) in the ROSU61 group experienced APR ( P 02=02not significant). No difference was found in fever and VAS measurements. CRP and granulocytes increased significantly in both groups; WBC count increased, while lymphocytes and eosinophils decreased significantly only in the ROSU61 group. In a post hoc analysis of only patients with an APR, all laboratory parameters exhibited a similar significant change solely within the ROSU61 group. In conclusion, our data suggest that a short course of ROS at this dose cannot prevent the ZOL-induced APR among osteoporotic women. Milder changes in acute-phase laboratory parameters in ROSU+ patients suggest that studies with higher doses may be warranted.