Abstract
Background: Zoledronic acid and teriparatide have been proved to be effective in improving bone metabolism and preventing fractures, but there is no clear clinical report on the efficacy of their combined application. Purpose: To discuss the clinical effect of zoledronic acid combined with teriparatide in perverting recurrent fracture of osteoporotic vertebral compressive fractures (OVCF) in the elderly after percutaneous kyphoplasty (PKP). Method: A randomized clinical trial was conducted at the First Affiliated Hospital of Hebei North University in China from September 2018 and September 2019. A total of 60 patients with OVCF were enrolled in the study (zoledronic acid: 20 cases; teriparatide: 20 cases; zoledronic acid + teriparatide: 20 cases). Observe and compare the changes of bone mineral density (BMD), pro-collagen type I N-terminal propeptide (PINP) and cross-linked C-terminal telopeptide of type I collagen (β-CTX) before surgery, 6 months and 1 year after surgery. At the same time, secondary fracture events and adverse reaction events were recorded during the follow-up period. Results: After normalized treatment, the bone metabolism indexes of PINP and β-CTX were improved and BMD was increased in three groups. Adverse Reactions: There was no statistical significance in the incidence of fever, gastrointestinal reactions and myalgia among the three groups (P > 0.05). The incidence of recurrent fractures in group A was higher than that in group C (P 0.05). Conclusion: Zoledronic acid combined with teriparatide is superior to Zoledronic acid in preventing the risk of recurrent fracture after PKP for old patients with OVCF, but it has no significant advantage over teriparatide.
Highlights
According to statistics, the number of people over 65 who suffer from osteoporosis in China is as high as 144 million, and the number of patients with fracture caused by osteoporosis (OP) is increasing year by year
In terms of improving bone mineral density (BMD), group C was better than group B, and group B was better than group A (Table 4)
This study shows that zoledronic acid combined with teriparatide in the prevention of recurrent fractures has no significant difference with teriparatide monotherapy group, its improvement in BMD, β-CTX is still better than teriparatide monotherapy group
Summary
The number of people over 65 who suffer from osteoporosis in China is as high as 144 million, and the number of patients with fracture caused by osteoporosis (OP) is increasing year by year. Since the introduction of percutaneous kyphoplasty/vertebroplasty (PKP/PVP) into China in the 1980s, they have gradually developed and become the main surgical treatment for OVCF [4] [5]. To find appropriate anti-OP medicines is the key to prevent the recurrence of OVCF after PKP. Zoledronic acid and teriparatide have been proved to be effective in improving bone metabolism and preventing fractures, but there is no clear clinical report on the efficacy of their combined application. Purpose: To discuss the clinical effect of zoledronic acid combined with teriparatide in perverting recurrent fracture of osteoporotic vertebral compressive fractures (OVCF) in the elderly after percutaneous kyphoplasty (PKP). Results: After normalized treatment, the bone metabolism indexes of PINP and β-CTX were improved and BMD was increased in three groups.
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