Introduction: Osteoporosis is a silent disorder characterised by decrease in bone mineral density however its sequalae, osteoporotic fractures are major cause of socio-economic burden to an individual as well as to society. It is a preventable disease. Numerous pharmaceutical agents have been described for treatment of osteoporosis, biphosphonates are considered to be as gold standard. Among various biphosphonates, we evaluated the efficacy of once yearly Zolendronic acid for the treatment of post menopausal osteoporosis.
Materials & methods: Total 72 postmenopausal osteoporotic females with T-score <-2.5, between age group 50- 75years, satisfying our inclusion criteria's, were recruited in our study. All patient were treated by giving yearly dose of 5 mg of Zolendronic acid in 100 ml of solution in slow intra-venous infusion along with calcium and Vit D. Bone mineral density and bio-markers were measured at base line. Bio-markers level were studied at 6 monthly interval than at yearly interval while BMD was repeated after 24 months. Adverse outcome was accessed in terms of occurrence of a fracture or death.
Results: BMD at spine ( 0.72±0.17 gm/cm2 to 0.89±0.11 gm/cm2) and hip (0.69±0.08 gm/cm2 to 0.81±0.07gm/cm2) were significantly (p<.05) higher from baseline, although increase in BMD at wrist (0.63±0.18gm/cm2 to 0.66±0.01gm/cm2 )was also observed but it was not significant as compare to baseline. Value of CTX was significantly lowered down from baseline(p<.05). We observed four cases of wrist, seven cases of hip and spinal fractures. 4 deaths were observed, two were after osteoporotic hip fracture morbidity.
Discussion: Osteoporotic fractures are major cause of morbidity, hip fractures are particularly notorious for their morbidity and mortality. Zolendronic acid is a long acting potent bisphosphonate and used for prevention as well as treatment of both vertebral and extra-vertebral fractures
Conclusion: We observed significant increase in BMD at hip and spine with use of Zolendronic acid among post menopausal females. It is a viable, cost effective option to increase bone mineral density in post menopausal osteoporosis patients with better patient compliance and lesser side effects.
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