title: Zoledronic acid in osteoporosis secondary to mastocytosis.
abstract: BACKGROUND
  Osteoporosis is the prevalent manifestation of bone involvement in patients with systemic mastocytosis. Mastocytosis-related osteoporosis is characterized by both absolute and relative prevalence of osteoclastic activity, consistent with the positive results reported in small series of patients with antiresorptive drugs, such as bisphosphonates. The aim of this study is to investigate the efficacy of zoledronic acid in patients with mastocytosis-related osteoporosis.
  
  
  METHODS
  Twenty-five patients with osteoporosis secondary to indolent systemic mastocytosis were given a single intravenous infusion of 5 mg zoledronic acid dissolved in 100 mL of 0.9% saline over 60 minutes.
  
  
  RESULTS
  After 1 year, the mean increase in bone mineral density was 6.0% ± 4.4% at the spine and 2.4% ± 3.2% at the total hip. Serum levels of bone turnover markers decreased versus baseline: bone alkaline phosphatase -34% and -35%, and C-terminal telopeptide -68% and -56% at 6 and 12 months, respectively. None of the patients reported new fractures during the year of follow-up. In all the first 20 treated patients, a transitory acute phase response was observed, but this was prevented in 4 of 5 subsequent patients in whom acetaminophen was given systematically during the 3 days post-infusion.
  
  
  CONCLUSIONS
  A single 5 mg zoledronic acid intravenous infusion in patients with osteoporosis secondary to indolent systemic mastocytosis is associated with significant increases in spine and hip bone mineral density and decreases of bone turnover markers over at least 1 year. Yearly zoledronic acid might represent a therapeutic option for indolent systemic mastocytosis-associated osteoporosis.
authors: Rheumatology Section, Department of Medicine, University of Verona, Italy. Electronic address: maurizio.rossini@univr.it.
authors: Maurizio
authors: M
authors: Rossini
authors: Hematology Section, Department of Medicine, University of Verona, Italy.
authors: Roberta
authors: R
authors: Zanotti
authors: Rheumatology Section, Department of Medicine, University of Verona, Italy.
authors: Ombretta
authors: O
authors: Viapiana
authors: Rheumatology Section, Department of Medicine, University of Verona, Italy.
authors: Gaia
authors: G
authors: Tripi
authors: Rheumatology Section, Department of Medicine, University of Verona, Italy.
authors: Luca
authors: L
authors: Idolazzi
authors: Rheumatology Section, Department of Medicine, University of Verona, Italy.
authors: Marta
authors: M
authors: Biondan
authors: Rheumatology Section, Department of Medicine, University of Verona, Italy.
authors: Giovanni
authors: G
authors: Orsolini
authors: Allergy Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
authors: Patrizia
authors: P
authors: Bonadonna
authors: Rheumatology Section, Department of Medicine, University of Verona, Italy.
authors: Silvano
authors: S
authors: Adami
authors: Rheumatology Section, Department of Medicine, University of Verona, Italy.
authors: Davide
authors: D
authors: Gatti
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D024042:Collagen Type I / Q000097:blood; D004164:Diphosphonates / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D008297:Male; D034721:Mastocytosis, Systemic / Q000150:complications*; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy* / Q000209:etiology; D010455:Peptides / Q000097:blood; D000077211:Zoledronic Acid
chemical_list: D050071:Bone Density Conservation Agents; D024042:Collagen Type I; D004164:Diphosphonates; D007093:Imidazoles; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D000077211:Zoledronic Acid; D000469:Alkaline Phosphatase
keywords: Bisphosphonates; Bone mineral density; Bone turnover markers; Mastocytosis; Osteoporosis; Zoledronic acid