title: Effect of zoledronic acid on markers of bone turnover and mineral density in osteoporotic patients with beta-thalassaemia.
abstract: Osteoporosis has emerged as an important cause of morbidity in patients with thalassemia major. Studies regarding the efficacy of bisphosphonates in thalassemia-induced osteoporosis have yielded conflicting results. We performed this prospective study to evaluate the efficacy of zoledronic acid in osteoporotic patients with thalassemia major. Patients, 29, were given 1 mg zoledronic acid intravenously every 3 months for a total of four doses. Twenty age- and sex-matched healthy blood donors served as controls. Before each infusion and 3 months after the last infusion, we determined serum levels of osteoprotegerin (OPG), N-terminal cross-linking telopeptide of type I collagen (NTX), osteocalcin (OC) and insulin-like growth factor 1 (IGF-1). Bone mineral density (BMD) of the lumbar spine was measured at baseline and after the treatment's completion. At baseline, OPG did not differ significantly between patients and controls (p=0.2), NTX were higher in patients although not significantly (p=0.139), whereas, OC levels were significantly higher and IGF-1 levels significantly lower in patients than in controls (p<0.001 and p<0.006, respectively). Zoledronic acid administration resulted in a significant decrease in NTX, OC and IGF-1 (p<0.05, p<0.001 and p<0.05, respectively) and in a significant increase in OPG and BMD (p<0.05 for both comparisons). The change in NTX, osteocalcin and IGF-1 became significant as early as 3 months after the first administration of zoledronic acid, while the change in OPG reached significance only after three infusions. Our study supports the effectiveness of bisphosphonates in the treatment of thalassemia-induced osteoporosis.
authors.affiliation: Thalassaemia Unit, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece.
authors.forename: Vassilios
authors.initials: V
authors.lastname: Perifanis
authors.forename: Timoleon
authors.initials: T
authors.lastname: Vyzantiadis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Tziomalos
authors.forename: Sofia
authors.initials: S
authors.lastname: Vakalopoulou
authors.forename: Vassilia
authors.initials: V
authors.lastname: Garipidou
authors.forename: Miranda
authors.initials: M
authors.lastname: Athanassiou-Metaxa
authors.forename: Faidon
authors.initials: F
authors.lastname: Harsoulis
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000494:pharmacology / Q000627:therapeutic use; D001842:Bone and Bones / Q000187:drug effects / Q000378:metabolism*; D024042:Collagen Type I / Q000097:blood; D004164:Diphosphonates / Q000494:pharmacology* / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000494:pharmacology* / Q000627:therapeutic use*; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D015675:Osteocalcin / Q000097:blood; D010024:Osteoporosis / Q000188:drug therapy* / Q000209:etiology*; D053244:Osteoprotegerin / Q000097:blood; D010455:Peptides / Q000097:blood; D016896:Treatment Outcome; D000077211:Zoledronic Acid; D017086:beta-Thalassemia / Q000150:complications*
chemical_list: D015415:Biomarkers; D050071:Bone Density Conservation Agents; D024042:Collagen Type I; D004164:Diphosphonates; D007093:Imidazoles; D053244:Osteoprotegerin; D010455:Peptides; C506030:TNFRSF11B protein, human; C052929:collagen type I trimeric cross-linked peptide; D015675:Osteocalcin; D007334:Insulin-Like Growth Factor I; D000077211:Zoledronic Acid