281 Side-effects associated with IV Zoledronic Acid infusion in patients with osteoporosis
Abstract Background Osteoporosis is a common condition affecting bone, leading to fragility and fractures. Oral bisphosphonates are the first line treatment for osteoporosis reducing vertebral, hip and non-vertebral fractures. However poor compliance and Gastro-Intestinal (GI) intolerance result in...
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| description | Abstract
Background
Osteoporosis is a common condition affecting bone, leading to fragility and fractures. Oral bisphosphonates are the first line treatment for osteoporosis reducing vertebral, hip and non-vertebral fractures. However poor compliance and Gastro-Intestinal (GI) intolerance result in poor persistence. Intravenous Zoledronic Acid (IV ZA) is an effective alternative therapy, improving compliance and tolerability. Side effects have been reported such as fever, flu-like symptoms, myalgia, arthralgia, headache, uveitis, iritis and hypocalcaemia.
Methods
This prospective observational study was carried out in a dedicated Bone Health Service. Patients diagnosed with osteoporosis were assessed by the Bone Health team regarding suitability for IV ZA. Infusions were administered in a nurse-led IV ZA clinic. Pre and 1-week post infusion bloods including Renal, Liver and Bone profile, Parathyroid hormone, Vitamin D and bone markers- Osteocalcin, CTX, PINP were taken. Side effects post infusion were recorded.
Results
N = 189. 161:28 female to male ratio. Age range 32-90 years, median 61 years. All diagnosed with osteoporosis in hip and/or spine. Forty-three percent were bisphosphonate naïve. 51 (27%) attended GP for post infusion bloods while 7 patients received infusion while inpatients. 29% of those returning to clinic for post infusion bloods reported side effects. Treatment naïve and treatment experienced reported similar rate of side effect 21%/20% respectively. Most common side effects include flu-like symptoms (31%) with fatigue/tiredness/generalised aches and pains/GI upset 16% respectively. 10% reported headaches while 5% experienced sore/swollen eyes. Rash, swollen joints and pre-syncope experienced by 3% respectively. Symptoms resolved after 24-48 hrs.
Conclusion
IV ZA is a well-established treatment for osteoporosis particularly for patients intolerant or poorly compliant with oral bisphosphonate therapy and an accepted treatment to close-off Denosumab. According to our study IV ZA is well tolerated with self-limiting side effects. However, pre infusion screening is essential to deem suitability. |
| doi_str_mv | 10.1093/ageing/afad156.224 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_3049092618</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/ageing/afad156.224</oup_id><sourcerecordid>3049092618</sourcerecordid><originalsourceid>FETCH-LOGICAL-c1098-8fd8e4b93d7c81d907d6c0fc6a2fcb9c5582fafe8fa12d36bb9d118593ab09e43</originalsourceid><addsrcrecordid>eNqNkE1LAzEQhoMoWKt_wFPA87b52N0mx1LUFgoe_Dj0ErLJpKbUzZrsIv57o9sf4Glm4HlnhgehW0pmlEg-13vw7X6unba0qmeMlWdoQstaFEzw8hxNCCGsIAsmL9FVSoc80oqyCdoxQfGzt1CAc2D6hHVKwXjdg8Vfvn_Hmze8C0ewMbTe4KXxFvvWDcmHNje4072HNuf-4JB6CF2IIfl0jS6cPia4OdUpen24f1mti-3T42a13BYmvy4K4ayAspHcLoygVpKFrQ1xptbMmUaaqhLMaQfCacosr5tGWkpFJbluiISST9HduLeL4XOA1KtDGGKbTypOSkkkq6nIFBspk59LEZzqov_Q8VtRon4dqtGhOjlU2WEOFWMoDN1_-B9iFnc_</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3049092618</pqid></control><display><type>article</type><title>281 Side-effects associated with IV Zoledronic Acid infusion in patients with osteoporosis</title><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Maher, N ; Fallon, N ; Caraher, J ; Steen, G ; O’Carroll, C ; Fitzgerald, D ; McCarroll, K ; Lannon, R</creator><creatorcontrib>Maher, N ; Fallon, N ; Caraher, J ; Steen, G ; O’Carroll, C ; Fitzgerald, D ; McCarroll, K ; Lannon, R</creatorcontrib><description>Abstract
Background
Osteoporosis is a common condition affecting bone, leading to fragility and fractures. Oral bisphosphonates are the first line treatment for osteoporosis reducing vertebral, hip and non-vertebral fractures. However poor compliance and Gastro-Intestinal (GI) intolerance result in poor persistence. Intravenous Zoledronic Acid (IV ZA) is an effective alternative therapy, improving compliance and tolerability. Side effects have been reported such as fever, flu-like symptoms, myalgia, arthralgia, headache, uveitis, iritis and hypocalcaemia.
Methods
This prospective observational study was carried out in a dedicated Bone Health Service. Patients diagnosed with osteoporosis were assessed by the Bone Health team regarding suitability for IV ZA. Infusions were administered in a nurse-led IV ZA clinic. Pre and 1-week post infusion bloods including Renal, Liver and Bone profile, Parathyroid hormone, Vitamin D and bone markers- Osteocalcin, CTX, PINP were taken. Side effects post infusion were recorded.
Results
N = 189. 161:28 female to male ratio. Age range 32-90 years, median 61 years. All diagnosed with osteoporosis in hip and/or spine. Forty-three percent were bisphosphonate naïve. 51 (27%) attended GP for post infusion bloods while 7 patients received infusion while inpatients. 29% of those returning to clinic for post infusion bloods reported side effects. Treatment naïve and treatment experienced reported similar rate of side effect 21%/20% respectively. Most common side effects include flu-like symptoms (31%) with fatigue/tiredness/generalised aches and pains/GI upset 16% respectively. 10% reported headaches while 5% experienced sore/swollen eyes. Rash, swollen joints and pre-syncope experienced by 3% respectively. Symptoms resolved after 24-48 hrs.
Conclusion
IV ZA is a well-established treatment for osteoporosis particularly for patients intolerant or poorly compliant with oral bisphosphonate therapy and an accepted treatment to close-off Denosumab. According to our study IV ZA is well tolerated with self-limiting side effects. However, pre infusion screening is essential to deem suitability.</description><identifier>ISSN: 0002-0729</identifier><identifier>EISSN: 1468-2834</identifier><identifier>DOI: 10.1093/ageing/afad156.224</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Acids ; Alternative medicine ; Arthralgia ; Bisphosphonates ; Bone ; Bones ; Collagen ; Compliance ; Fainting ; Family physicians ; Female to male ; Fractures ; Headaches ; Health services ; Hip ; Hypocalcemia ; Influenza ; Inpatient care ; Iritis ; Liver ; Medical screening ; Myalgia ; Nurse led services ; Osteocalcin ; Osteoporosis ; Parathyroid hormone ; Side effects ; Spine ; Suitability ; Symptoms ; Syncope ; Uveitis ; Vertebrae ; Vitamin D ; Zoledronic acid</subject><ispartof>Age and ageing, 2023-09, Vol.52 (Supplement_3)</ispartof><rights>The Author(s) 2023. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com 2023</rights><rights>The Author(s) 2023. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1584,27924,27925,30999</link.rule.ids></links><search><creatorcontrib>Maher, N</creatorcontrib><creatorcontrib>Fallon, N</creatorcontrib><creatorcontrib>Caraher, J</creatorcontrib><creatorcontrib>Steen, G</creatorcontrib><creatorcontrib>O’Carroll, C</creatorcontrib><creatorcontrib>Fitzgerald, D</creatorcontrib><creatorcontrib>McCarroll, K</creatorcontrib><creatorcontrib>Lannon, R</creatorcontrib><title>281 Side-effects associated with IV Zoledronic Acid infusion in patients with osteoporosis</title><title>Age and ageing</title><description>Abstract
Background
Osteoporosis is a common condition affecting bone, leading to fragility and fractures. Oral bisphosphonates are the first line treatment for osteoporosis reducing vertebral, hip and non-vertebral fractures. However poor compliance and Gastro-Intestinal (GI) intolerance result in poor persistence. Intravenous Zoledronic Acid (IV ZA) is an effective alternative therapy, improving compliance and tolerability. Side effects have been reported such as fever, flu-like symptoms, myalgia, arthralgia, headache, uveitis, iritis and hypocalcaemia.
Methods
This prospective observational study was carried out in a dedicated Bone Health Service. Patients diagnosed with osteoporosis were assessed by the Bone Health team regarding suitability for IV ZA. Infusions were administered in a nurse-led IV ZA clinic. Pre and 1-week post infusion bloods including Renal, Liver and Bone profile, Parathyroid hormone, Vitamin D and bone markers- Osteocalcin, CTX, PINP were taken. Side effects post infusion were recorded.
Results
N = 189. 161:28 female to male ratio. Age range 32-90 years, median 61 years. All diagnosed with osteoporosis in hip and/or spine. Forty-three percent were bisphosphonate naïve. 51 (27%) attended GP for post infusion bloods while 7 patients received infusion while inpatients. 29% of those returning to clinic for post infusion bloods reported side effects. Treatment naïve and treatment experienced reported similar rate of side effect 21%/20% respectively. Most common side effects include flu-like symptoms (31%) with fatigue/tiredness/generalised aches and pains/GI upset 16% respectively. 10% reported headaches while 5% experienced sore/swollen eyes. Rash, swollen joints and pre-syncope experienced by 3% respectively. Symptoms resolved after 24-48 hrs.
Conclusion
IV ZA is a well-established treatment for osteoporosis particularly for patients intolerant or poorly compliant with oral bisphosphonate therapy and an accepted treatment to close-off Denosumab. According to our study IV ZA is well tolerated with self-limiting side effects. However, pre infusion screening is essential to deem suitability.</description><subject>Acids</subject><subject>Alternative medicine</subject><subject>Arthralgia</subject><subject>Bisphosphonates</subject><subject>Bone</subject><subject>Bones</subject><subject>Collagen</subject><subject>Compliance</subject><subject>Fainting</subject><subject>Family physicians</subject><subject>Female to male</subject><subject>Fractures</subject><subject>Headaches</subject><subject>Health services</subject><subject>Hip</subject><subject>Hypocalcemia</subject><subject>Influenza</subject><subject>Inpatient care</subject><subject>Iritis</subject><subject>Liver</subject><subject>Medical screening</subject><subject>Myalgia</subject><subject>Nurse led services</subject><subject>Osteocalcin</subject><subject>Osteoporosis</subject><subject>Parathyroid hormone</subject><subject>Side effects</subject><subject>Spine</subject><subject>Suitability</subject><subject>Symptoms</subject><subject>Syncope</subject><subject>Uveitis</subject><subject>Vertebrae</subject><subject>Vitamin D</subject><subject>Zoledronic acid</subject><issn>0002-0729</issn><issn>1468-2834</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><recordid>eNqNkE1LAzEQhoMoWKt_wFPA87b52N0mx1LUFgoe_Dj0ErLJpKbUzZrsIv57o9sf4Glm4HlnhgehW0pmlEg-13vw7X6unba0qmeMlWdoQstaFEzw8hxNCCGsIAsmL9FVSoc80oqyCdoxQfGzt1CAc2D6hHVKwXjdg8Vfvn_Hmze8C0ewMbTe4KXxFvvWDcmHNje4072HNuf-4JB6CF2IIfl0jS6cPia4OdUpen24f1mti-3T42a13BYmvy4K4ayAspHcLoygVpKFrQ1xptbMmUaaqhLMaQfCacosr5tGWkpFJbluiISST9HduLeL4XOA1KtDGGKbTypOSkkkq6nIFBspk59LEZzqov_Q8VtRon4dqtGhOjlU2WEOFWMoDN1_-B9iFnc_</recordid><startdate>20230914</startdate><enddate>20230914</enddate><creator>Maher, N</creator><creator>Fallon, N</creator><creator>Caraher, J</creator><creator>Steen, G</creator><creator>O’Carroll, C</creator><creator>Fitzgerald, D</creator><creator>McCarroll, K</creator><creator>Lannon, R</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope></search><sort><creationdate>20230914</creationdate><title>281 Side-effects associated with IV Zoledronic Acid infusion in patients with osteoporosis</title><author>Maher, N ; Fallon, N ; Caraher, J ; Steen, G ; O’Carroll, C ; Fitzgerald, D ; McCarroll, K ; Lannon, R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1098-8fd8e4b93d7c81d907d6c0fc6a2fcb9c5582fafe8fa12d36bb9d118593ab09e43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Acids</topic><topic>Alternative medicine</topic><topic>Arthralgia</topic><topic>Bisphosphonates</topic><topic>Bone</topic><topic>Bones</topic><topic>Collagen</topic><topic>Compliance</topic><topic>Fainting</topic><topic>Family physicians</topic><topic>Female to male</topic><topic>Fractures</topic><topic>Headaches</topic><topic>Health services</topic><topic>Hip</topic><topic>Hypocalcemia</topic><topic>Influenza</topic><topic>Inpatient care</topic><topic>Iritis</topic><topic>Liver</topic><topic>Medical screening</topic><topic>Myalgia</topic><topic>Nurse led services</topic><topic>Osteocalcin</topic><topic>Osteoporosis</topic><topic>Parathyroid hormone</topic><topic>Side effects</topic><topic>Spine</topic><topic>Suitability</topic><topic>Symptoms</topic><topic>Syncope</topic><topic>Uveitis</topic><topic>Vertebrae</topic><topic>Vitamin D</topic><topic>Zoledronic acid</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Maher, N</creatorcontrib><creatorcontrib>Fallon, N</creatorcontrib><creatorcontrib>Caraher, J</creatorcontrib><creatorcontrib>Steen, G</creatorcontrib><creatorcontrib>O’Carroll, C</creatorcontrib><creatorcontrib>Fitzgerald, D</creatorcontrib><creatorcontrib>McCarroll, K</creatorcontrib><creatorcontrib>Lannon, R</creatorcontrib><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><jtitle>Age and ageing</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Maher, N</au><au>Fallon, N</au><au>Caraher, J</au><au>Steen, G</au><au>O’Carroll, C</au><au>Fitzgerald, D</au><au>McCarroll, K</au><au>Lannon, R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>281 Side-effects associated with IV Zoledronic Acid infusion in patients with osteoporosis</atitle><jtitle>Age and ageing</jtitle><date>2023-09-14</date><risdate>2023</risdate><volume>52</volume><issue>Supplement_3</issue><issn>0002-0729</issn><eissn>1468-2834</eissn><abstract>Abstract
Background
Osteoporosis is a common condition affecting bone, leading to fragility and fractures. Oral bisphosphonates are the first line treatment for osteoporosis reducing vertebral, hip and non-vertebral fractures. However poor compliance and Gastro-Intestinal (GI) intolerance result in poor persistence. Intravenous Zoledronic Acid (IV ZA) is an effective alternative therapy, improving compliance and tolerability. Side effects have been reported such as fever, flu-like symptoms, myalgia, arthralgia, headache, uveitis, iritis and hypocalcaemia.
Methods
This prospective observational study was carried out in a dedicated Bone Health Service. Patients diagnosed with osteoporosis were assessed by the Bone Health team regarding suitability for IV ZA. Infusions were administered in a nurse-led IV ZA clinic. Pre and 1-week post infusion bloods including Renal, Liver and Bone profile, Parathyroid hormone, Vitamin D and bone markers- Osteocalcin, CTX, PINP were taken. Side effects post infusion were recorded.
Results
N = 189. 161:28 female to male ratio. Age range 32-90 years, median 61 years. All diagnosed with osteoporosis in hip and/or spine. Forty-three percent were bisphosphonate naïve. 51 (27%) attended GP for post infusion bloods while 7 patients received infusion while inpatients. 29% of those returning to clinic for post infusion bloods reported side effects. Treatment naïve and treatment experienced reported similar rate of side effect 21%/20% respectively. Most common side effects include flu-like symptoms (31%) with fatigue/tiredness/generalised aches and pains/GI upset 16% respectively. 10% reported headaches while 5% experienced sore/swollen eyes. Rash, swollen joints and pre-syncope experienced by 3% respectively. Symptoms resolved after 24-48 hrs.
Conclusion
IV ZA is a well-established treatment for osteoporosis particularly for patients intolerant or poorly compliant with oral bisphosphonate therapy and an accepted treatment to close-off Denosumab. According to our study IV ZA is well tolerated with self-limiting side effects. However, pre infusion screening is essential to deem suitability.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><doi>10.1093/ageing/afad156.224</doi></addata></record> |
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| ispartof | Age and ageing, 2023-09, Vol.52 (Supplement_3) |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Acids Alternative medicine Arthralgia Bisphosphonates Bone Bones Collagen Compliance Fainting Family physicians Female to male Fractures Headaches Health services Hip Hypocalcemia Influenza Inpatient care Iritis Liver Medical screening Myalgia Nurse led services Osteocalcin Osteoporosis Parathyroid hormone Side effects Spine Suitability Symptoms Syncope Uveitis Vertebrae Vitamin D Zoledronic acid |
| title | 281 Side-effects associated with IV Zoledronic Acid infusion in patients with osteoporosis |
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