[Risk factors of acute-phase response following the first-dose administration of zoledronic acid in the treatment of osteoporosis].
OBJECTIVE
To explore the risk factors of acute-phase response (APR) following the first-dose administration of zoledronic acid in the treatment of osteoporosis.


METHODS
We reviewed the clinical data of the patients receiving the first use of zoledronic acid 5 mg treatment of osteoporosis from January 2009 to November 2012, and divided the patients into acute phase response group (APR+) and no response group (APR-). The age, body mass index (BMI), concomitant medications, comorbidities, laboratory parameters between the two groups were compared and analyzed.


RESULTS
A total of 178 patients were eligible for inclusion in the study, of which 108 patients experienced APR. In APR group, there were 80 (44. 9%) patients developed fever, 14 (9. 6%) chills, 48 (27.0%) musculoskeletal pain, 19 (10.7%) gastrointestinal symptoms, 10 (5.6%) headache and dizziness, 7 (3.9%) palpitation,and 3 (1.7%) rash. APR was more common in the patients with higher baseline tartrate-resistant acid phosphatase 5b (TRACP-5b) and new-onset vertebral compression fractures (new-onset VCF). Stepwise logistic regression showed that the odds ratio (OR) of APR in higher baseline TRACP-5b and new VCF was 3. 3 and 2. 5 respectively.


CONCLUSIONS
The first use of zoledronic acid in the treatment of osteoporosis appears high incidence of APR. High TRACP-5b levels and new vertebral fracture are risk factors for APR.
Department of Endocrinology, West China Hospital, Sichuan University, Chengdu 610041, China
Yan
Y
Chen
Chun-Yan
CY
Lu
Ting
T
Liu
Yan-Hong
YH
Guo
Qin
Q
Wang
De-Cai
DC
Chen
D000135:Acid Phosphatase / Q000097:blood; D000210:Acute-Phase Reaction / Q000209:etiology*; D000368:Aged; D004164:Diphosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects* / Q000627:therapeutic use; D007527:Isoenzymes / Q000097:blood; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy*; D012307:Risk Factors; D000071681:Tartrate-Resistant Acid Phosphatase; D000077211:Zoledronic Acid
D004164:Diphosphonates; D007093:Imidazoles; D007527:Isoenzymes; D000077211:Zoledronic Acid; C000605510:ACP5 protein, human; D000135:Acid Phosphatase; D000071681:Tartrate-Resistant Acid Phosphatase