Longitudinal changes in bone mineral density and trabecular bone score following yearly zoledronic acid infusion in postmenopausal osteoporosis-a retrospective-prospective study from southern India.

Abstract

There is limited information available with regard to the impact of zoledronic acid treatment on bone mineral density (BMD) and trabecular bone score (TBS) in Indian postmenopausal women with osteoporosis. We studied the changes in BMD at femoral neck (FN), hip and lumbar spine (LS), and in TBS following yearly administration of zoledronic acid (ZA) in subjects with postmenopausal osteoporosis. This was a prospective-retrospective study which included subjects on follow-up after administration of yearly zoledronic acid, over the past 6years. Postmenopausal women with a T score of ≤ - 2.5 at any site, assessed by dual energy X-ray absorptiometry (DXA), were included. A total of 620 subjects had received ZA during the study period, 197 postmenopausal women were eligible, and follow-up data were available in 164 and 103 at 1st and 2nd follow-up yearly visits respectively. The mean (SD) age and BMI of the women were 63.2 (8.5) years and 25.6 (4.5)kg/m2 respectively. There was significant increment in LS BMD from baseline to the 1st and 2nd follow-up visits, respectively (mean (SD), 0.718 (0.116), 0.734 (0.104), 0.762 (0.127)g/cm2, p = 0.024). No decline in the BMD at FN and hip at first and second follow visit was found. The TBS scores (n = 90) on baseline and follow-up visits were 1.260 (±0.11), 1.256 (± 0.15), and 1.242 (± 0.17) (p value = 0.71). Lumbar spine BMD showed significant improvement with zoledronic acid treatment. No decline was noted in femoral neck BMD and TBS with treatment.