Inpatient zoledronic acid in older hip fracture patients is well tolerated and safe

Inpatient zoledronic acid in older hip fracture patients is well tolerated and safe

Summary Administering zoledronic acid (ZA) to older hip fracture patients during the hospital stay has faced safety concerns. However, in this study of 161 patients, no ZA-related side effects or readmissions were observed, demonstrating that ZA administration during hospitalization is safe and effe...

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Bibliographic Details
Published in:Archives of osteoporosis Vol. 19; no. 1; p. 96
Main Authors: Malgo, Frank, van Deudekom, Floor J. A., Hup, Roos, Formijne Jonkers, Henk A., Kempen, Diederik H. R., de Vries, Kerst, Willems, Hanna C., Vlug, Annegreet G.
Format: Journal Article
Language:English
Published: London Springer London 10-10-2024
Subjects:
Aged
Aged, 80 and over
Bone Density Conservation Agents - administration & dosage
Bone Density Conservation Agents - adverse effects
Bone Density Conservation Agents - therapeutic use
Endocrinology
Female
Follow-Up Studies
Hip Fractures
Hospitalization - statistics & numerical data
Humans
Male
Medicine
Medicine & Public Health
Original Article
Orthopedics
Osteoporosis - drug therapy
Osteoporotic Fractures - prevention & control
Retrospective Studies
Zoledronic Acid - administration & dosage
Zoledronic Acid - adverse effects
Zoledronic Acid - therapeutic use
Zoledronic acid
Osteoporosis
Hip fracture
Safety
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Summary:Summary Administering zoledronic acid (ZA) to older hip fracture patients during the hospital stay has faced safety concerns. However, in this study of 161 patients, no ZA-related side effects or readmissions were observed, demonstrating that ZA administration during hospitalization is safe and effective for secondary fracture prevention. Purpose According to the 2022 Dutch ‘Osteoporosis and fracture prevention’ guideline, zoledronic acid (ZA) is the preferred osteoporosis treatment for hip fracture patients. Less than 25% of hip fracture patients visit the outpatient fracture liaison service, therefore inpatient administration of ZA during the hip fracture hospitalization is now recommended in patients > 75 years. In the OLVG Hospital, inpatient administration of ZA during hospitalization for hip fracture in older patients has been standard of care since 2020. Methods This single center retrospective observational follow-up study included hip fracture patients > 75 years admitted to the orthogeriatric ward of the OLVG Hospital, and treated with 5 mg of ZA intravenously on the day of hospital discharge between June 2020 and December 2022. Life expectancy estimated < 12 months, creatinine clearance < 35 ml/min, hypocalcemia, and high risk of osteonecrosis of the jaw were contra-indications. During three months of follow-up (FU) adverse events, emergency room visits, hospital readmissions, and death were recorded. Results In 161 consecutive hospitalized hip fracture patients (mean age 86 ± 6 years, 65% female, 18% nursing home) ZA was administered and no adverse events were recorded. During 3 months of FU, 8 patients (5%) visited the emergency room, 19 patients (12%) were re-admitted to the hospital, 3 with a new fracture (2 contralateral hip, 1 radius), and 17 patients (11%) died of reasons unrelated to ZA. Conclusion This study shows that inpatient administration of zoledronic acid during hip fracture hospitalization is safe and feasible to prevent future fragility fractures in older hip fracture patients.
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ISSN:1862-3514
1862-3514
DOI:10.1007/s11657-024-01453-9