STUDY OF INCIDENCE OF OSTEOPOROSIS INDUCED FRACTURES IN THE ELDERLY AFTER ONCE YEARLY ZOLEDRONIC ACID INJECTION

Abstract

Introduction: In developing countries like India, the various socio-economic factors like anaemia, hypo proteinemia, early menopause, hysterectomy at younger age and loss of teeth at early age are leading causes of osteoporosis. The treatment for all the above problems at community level is difficult job. We advocated IV injections of Zoledronic acid once in a year which is feasible and possible way of preventing the progression of osteoporosis. This is evidenced by decrease in incidence of new fractures in our patients. Patients and Methods: We studied the efficacy of once yearly IV injection of Zoledronic acid -ZOLE to prevent osteoporotic fractures in the 130 elderly patients and compared the incidence of fractures in the placebo group of 150 patients who were not received the ZOLE injection. The age group ranges from 50 to 70 years who attended OP unit of our Orthopaedic department from January 2018 to December 2019 (2 years). These 280 patients presented with common fractures like fracture neck of femur-110, vertebral fractures-85, proximal tibial fractures-15, proximal humoral fractures-15 and distal radial fractures-55. IV Zoledronic acid was given to 130 patients in addition to fracture treatment. The remaining 150 patients who were not willing for IV injections for various reasons were included in the placebo group of our study. Results: We assessed the incidence of new fractures in both the groups patients, ZOLE group who received Zoledronic injection and placebo group who were not received injection for 2 years period. The incidence of new fractures was significantly diminished in ZOLE group compared to placebo group. We observed the incidence of all cumulative fractures were 30 fractures (24%) in the ZOLE group and in the placebo group the incidence was 110 fractures (76%). Bone mineral density (BMD) of Lumbar spine, femoral neck, proximal humerus and distal radius were done for all the patients at the time of starting of the study and at 2 years follow-up. We observed increased BMD in the ZOLE group. There were no adverse effects like osteonecrosis of jaw and others in our study. Conclusion: In rural areas of developing countries, with poor socioeconomic status, early osteoporosis is prevalent and causing the major fractures after trivial injury. Once yearly administration of Zoledronic acid 5 mg IV is safe and effective way of preventing the incidence of Fractures and subsequent morbidity and mortality.