Annual zoledronic acid dose reduces back pain disability

A yearly dose of zoledronic acid significantly reduced the number of days of disability because of back pain in older women with osteoporotic fractures, based on data from the HORIZON Pivotal fracture study.

“Osteoporotic fracture can result in back pain, significant disability, reduced quality of life, and death as per the University of Pittsburgh, which they wrote in a poster presented at the annual meeting of the American Geriatric Society.

One in three women aged 50 years and older will suffer an osteoporotic fracture, they noted. In the HORIZON Pivotal Fracture Study, a randomized controlled trial of more than 7,000 postmenopausal women aged 65-79 years, a yearly dose of 5mg zoledronic acid significantly reduced all types of clinical fractures, compared with placebo. The medication was administered in a 15-minute intravenous infusion.

In the current study, the researchers went a step further and compared the effect of the yearly dose of zoledronic acid on the number of days of disability, bed rest, and back pain. The intent-to-treat population included 3,875 women who received zoledronic acid and 3,861 who received placebo. The researchers collected information on days of limited activity and days of bed rest because of an osteoporotic fracture or back pain every 3 months during a 3-year period.

Older age and a prevalent vertebral fracture were significantly associated with more days of bed rest, back pain, and fracture-related disability.

Overall, women who took zoledronic acid averaged significantly fewer bed rest days because of fracture, compared with those in the placebo group (1.6 vs. 2.2 days respectively) and significantly fewer limited-activity days because of fracture, compared with the placebo group (5.9 vs. 9.9 days).

Similarly, the women who took zoledronic acid averaged significantly fewer bed rest days because of back pain, compared with those in the placebo group (8.2 vs 9.2 days respectively) and significantly fewer limited activity days because of back pain, compared with the placebo group (60.5 vs. 71.9 days).

After the investigators controlled for incident clinical fracture, zoledronic acid remained significantly associated with fewer days of limited activity from back pain.