Host LV, Keen HI, Laslett LL, Black DM, Jones G. Zoledronic acid does not slow spinal radiographic progression of osteoarthritis in postmenopausal women with osteoporosis and radiographic osteoarthritis.
Ther Adv Musculoskelet Dis 2022;
14:1759720X221081652. [PMID:
35844267 PMCID:
PMC9283639 DOI:
10.1177/1759720x221081652]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 01/25/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction:
Post hoc analyses of osteoporosis trials have suggested that
alendronate and strontium ranelate may be associated with a reduction in the
progression of spinal radiographic osteoarthritis (OA). We performed an
analysis on a subgroup of participants in the horizon PFT trial (a 3-year
randomized controlled trial (RCT) of yearly zoledronic acid (ZA) in
postmenopausal women with osteoporosis), to evaluate the effect of ZA on the
structural progression of spinal osteophytes (OPh) and disk space narrowing
(DN).
Methods:
Paired lateral spinal X-rays (baseline and 36 months) were selected from the
horizon PFT trial records restricted to those with radiographic OA at
baseline. The X-rays were analyzed by two readers blinded to the treatment
allocation. OPh and DN were scored separately using the Lane atlas (0–3 for
increasing severity at each vertebral level) at all evaluable levels from
T4–12 and L1–5.
Results:
A total of 504 sets of paired radiographs were included in the analysis, 245
in the ZA group and 259 in the placebo group. Overall, the rates of change
of OPh and DN scores were low, and they were not statistically different
between the groups (change in the whole spine OPh ZA 1.0 ± 1.6, placebo
0.8 ± 1.3, p = 0.1; DN ZA 0.3 ± 1.0, placebo 0.3 ± 0.8,
p = 0.7).
Conclusion:
Yearly ZA for 3 years was not associated with a slowing of progression of OPh
or DN in the thoracolumbar spine in patients with pre-existing radiographic
OA.
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