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Randomized Controlled Trial
. 2010 Jul;21(7):1277-85.
doi: 10.1007/s00198-009-1077-9. Epub 2009 Oct 3.

Effect of once-yearly zoledronic acid on the spine and hip as measured by quantitative computed tomography: results of the HORIZON Pivotal Fracture Trial

R Eastell  1 , T Lang, S Boonen, S Cummings, P D Delmas, J A Cauley, Z Horowitz, E Kerzberg, G Bianchi, D Kendler, P Leung, Z Man, P Mesenbrink, E F Eriksen, D M Black; HORIZON Pivotal Fracture Trial
Collaborators, Affiliations
Randomized Controlled Trial

Effect of once-yearly zoledronic acid on the spine and hip as measured by quantitative computed tomography: results of the HORIZON Pivotal Fracture Trial

R Eastell et al. Osteoporos Int. 2010 Jul.

Abstract

Changes in bone mineral density and bone strength following treatment with zoledronic acid (ZOL) were measured by quantitative computed analysis (QCT) or dual-energy X-ray absorptiometry (DXA). ZOL treatment increased spine and hip BMD vs placebo, assessed by QCT and DXA. Changes in trabecular bone resulted in increased bone strength.

Introduction: To investigate bone mineral density (BMD) changes in trabecular and cortical bone, estimated by quantitative computed analysis (QCT) or dual-energy X-ray absorptiometry (DXA), and whether zoledronic acid 5 mg (ZOL) affects bone strength.

Methods: In 233 women from a randomized, controlled trial of once-yearly ZOL, lumbar spine, total hip, femoral neck, and trochanter were assessed by DXA and QCT (baseline, Month 36). Mean percentage changes from baseline and between-treatment differences (ZOL vs placebo, t-test) were evaluated.

Results: Mean between-treatment differences for lumbar spine BMD were significant by DXA (7.0%, p < 0.01) and QCT (5.7%, p < 0.0001). Between-treatment differences were significant for trabecular spine (p = 0.0017) [non-parametric test], trabecular trochanter (10.7%, p < 0.0001), total hip (10.8%, p < 0.0001), and compressive strength indices at femoral neck (8.6%, p = 0.0001), and trochanter (14.1%, p < 0.0001).

Conclusions: Once-yearly ZOL increased hip and spine BMD vs placebo, assessed by QCT vs DXA. Changes in trabecular bone resulted in increased indices of compressive strength.

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Conflict of interest statement

Dr. Eastell serves as a consultant, has received honoraria for speaking, and has received grant funding from Novartis, Amgen, Sanofi-Aventis, Lilly, Organon, Pfizer, and Procter & Gamble Pharmaceuticals. Dr. Lang serves as a consultant for Merck and has received grant funding from Novartis. Dr. Boonen serves as a consultant, has received honoraria for speaking, and has received grant funding from Novartis. Dr. Cummings reports no conflict of interest. Dr. Cauley has received research grants from Merck, Eli Lilly, Pfizer, Novartis and Procter & Gamble, and has received honoraria from Novartis. Dr. Horowitz was an employee of Novartis until 2003. He has no other conflict of interest. Dr. Kerzberg has no conflict of interest. Dr. Bianchi has received consulting fees from Novartis. Dr. Kendler serves on advisory boards or as a consultant for Novartis, Servier, Eli Lilly, Amgen, Wyeth and Nycomed. Dr. Leung has no conflict of interest. Dr. Man has received honoraria for speaking from Sanofi-Aventis, Roche, Merck and Novartis. Dr. Mesenbrink is an employee of Novartis Pharmaceuticals Corporation who funded the study and owns stock in the company. Dr. Eriksen serves as a consultant and has received honoraria for speaking from Novartis. Dr. Black serves as a consultant for Nycomed and Zosano, and has research contracts with Novartis and Roche.

Figures

Fig. 1
Fig. 1
Change in DXA and QCT measures over 36 months in response to zoledronic acid (5 mg) or placebo at the spine and hip. a Change in bmd at the spine and hip as measured by DXA and QCT. b Change in trabecular and cortical bone at the hip measured by QCT. c Change in bone strength indicies measured by QCT. *p<0.001. ns non-significant
See this image and copyright information in PMC

References

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