Analysis Of The Efficacy,Safety And Compliance Of Zoledronic Acid In The Treatment Of Primary Osteoporosis In The Real World

Objective:To observe the clinical efficacy,safety and compliance of real-world zoledronic acid in the treatment of primary osteoporosis.Methods:Patients with primary osteoporosis treated in Jiangxi Provincial people’s Hospital from January 2013 to February 2023 who received at least one intravenous drip of zoledronic acid 5mg were selected as the study subjects.According to the frequency of drug use,zoledronic acid treatment 1 times group(n = 157),two times group(n =205),three times group(n = 143),four times group(n = 40)and five times group(n =20)were selected.The general data,bone mineral density and T value(lumbar vertebra 1-4,femoral neck,total hip),bone turnover markers,blood routine,biochemical indexes,fracture occurrence and adverse reactions after treatment were collected and compared.The observation time was baseline,once a year after treatment and once after treatment,and a comparison was made before and after treatment.Results:A total of 565 patients with primary osteoporosis were included in this study,including 157,205,143,40 and 20 patients in groups 1,2,3,4 and 5,respectively.Compared with the baseline,the bone mineral density of lumbar vertebrae increased by 4.7%,5.4%,8.7%,9.4% and 5.4% respectively in 1-5 years,and the difference was statistically significant(P < 0.01).The bone mineral density of femoral neck increased by 0.9%,1.3%,1.6%,1.4% and 0.4%,respectively.The bone mineral density of the whole hip joint increased by 2.2%,2.1%,2.4%,2.4% and 1.9%respectively,and the difference was not statistically significant.The bone turnover index decreased significantly compared with the baseline.After 1-4 years of treatment,the serum P1 NP decreased by 50.7%,53.4%,43.9% and 44.7% respectively,and theβ-CTX decreased by 60%,62%,56% and 52% respectively compared with the baseline.OC decreased by 40.8%,41.3%,37.4% and 28.3% respectively compared with the baseline(P < 0.01).New fractures occurred in 43 cases(7.6%)in the first year after zoledronic acid treatment,16 cases(3.9%)in 1 year after the second treatment,and 5 cases(2.5%)in 1 year after the third treatment.No new fractures were found after the fourth and fifth treatments.A total of 453 cases(80.2%)had adverse reactions after zoledronic acid treatment for the first time,12 cases(2.9%)had adverse reactions after the second treatment,and only 1 case(0.5%)had adverse reactions after the third or more treatments.no mandibular necrosis,uveitis,atypical femoral fracture and cardiovascular events were found during the treatment.Conclusion:(1)Zoledronic acid can increase bone mineral density and decrease bone turnover index in patients with primary osteoporosis.(2)With the increase of the frequency of zoledronic acid treatment,the new bone fracture rate of patients decreased year by year.(3)Most patients only had transient fever and myalgia after the first intravenous drip of zoledronic acid,and no other adverse events occurred.(4)In the real world,there are few patients with standardized and prescribed medication,and their compliance is low.