Dataset Information

Zoledronic acid versus alendronate for the prevention of bone loss after heart or liver transplantation.

ABSTRACT:

Context

The first year after transplantation is characterized by rapid bone loss.

Objective

The aim of this study was to compare zoledronic acid (zoledronate) and alendronate for prevention of transplantation bone loss.

Design and setting

A randomized clinical trial was conducted at a transplantation center.

Patients

The study included 84 adults undergoing heart or liver transplantation and a concurrently transplanted, nonrandomized reference group of 27 adults with T scores greater than -1.5.

Interventions

Alendronate (70 mg weekly for 12 months) or one 5-mg infusion of zoledronate were both initiated 26 ± 8 d after transplantation.

Main outcome measures

The primary outcome was total hip bone mineral density (BMD) 1 yr after transplantation. Secondary outcomes included femoral neck and lumbar spine BMD and serum C-telopeptide, a bone resorption marker.

Results

In the reference group, BMD declined at the spine and hip (P < 0.001). In the randomized groups, hip BMD remained stable. Spine BMD increased in the zoledronate group and did not change in the alendronate group; at 12 months, the 2.2% difference between groups (95% confidence interval, 0.6 to 3.9%; P = 0.009) favored zoledronate. In heart transplant patients, spine BMD declined in the alendronate and increased in the zoledronate group (-3.0 vs. +1.6%, respectively; between-group difference, 4.2%; 95% confidence interval, 2.1 to 6.3%; P < 0.001). In liver transplant patients, spine BMD increased comparably in both groups. Twelve-month C-telopeptide was lower in the zoledronate group than in the alendronate group (79 vs. 49%; P = 0.04).

Conclusions

One 5-mg infusion of zoledronate and weekly alendronate prevent bone loss at the hip and, in liver transplant patients, increase spine BMD. In heart transplant patients, spine bone BMD remained stable with zoledronate but decreased with alendronate.

SUBMITTER: Shane E

PROVIDER: S-EPMC3591679 | biostudies-literature | 2012 Dec

REPOSITORIES: biostudies-literature

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Publications

Zoledronic acid versus alendronate for the prevention of bone loss after heart or liver transplantation.

Shane Elizabeth E Cohen Adi A Stein Emily M EM McMahon Donald J DJ Zhang Chiyuan C Young Polly P Pandit Kavita K Staron Ronald B RB Verna Elizabeth C EC Brown Robert R Restaino Susan S Mancini Donna D

The Journal of clinical endocrinology and metabolism 20120928 12

<h4>Context</h4>The first year after transplantation is characterized by rapid bone loss.<h4>Objective</h4>The aim of this study was to compare zoledronic acid (zoledronate) and alendronate for prevention of transplantation bone loss.<h4>Design and setting</h4>A randomized clinical trial was conducted at a transplantation center.<h4>Patients</h4>The study included 84 adults undergoing heart or liver transplantation and a concurrently transplanted, nonrandomized reference group of 27 adults with ...[more]

PMID: 23024190

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Dataset Information

Zoledronic acid versus alendronate for the prevention of bone loss after heart or liver transplantation.

Context

Objective

Design and setting

Patients

Interventions

Main outcome measures

Results

Conclusions

Publications

Zoledronic acid versus alendronate for the prevention of bone loss after heart or liver transplantation.

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