Comparison of a Single Infusion of Zoledronic Acid with Risedronate for Paget's Disease

• Published in: The New England journal of medicine Vol. 353; no. 9; pp. 898 - 908
• Main Authors: Reid, Ian R, Miller, Paul, Lyles, Kenneth, Fraser, William, Brown, Jacques P, Saidi, Youssef, Mesenbrink, Peter, Su, Guoqin, Pak, Judy, Zelenakas, Ken, Luchi, Monica, Richardson, Peter, Hosking, David
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 01-09-2005
• Subjects: Administration, Oral; Aged; Alkaline Phosphatase - blood; Biological and medical sciences; Biomarkers - blood; Bone and Bones - drug effects; Bone and Bones - pathology; Bone density; Bone Remodeling - drug effects; Clinical trials; Diphosphonates - administration & dosage; Diphosphonates - adverse effects; Diphosphonates - therapeutic use; Double-Blind Method; Etidronic Acid - adverse effects; Etidronic Acid - analogs & derivatives; Etidronic Acid - pharmacology; Etidronic Acid - therapeutic use; Female; General aspects; Humans; Imidazoles - administration & dosage; Imidazoles - adverse effects; Imidazoles - therapeutic use; Infusions, Intravenous; Male; Medical sciences; Osteitis Deformans - blood; Osteitis Deformans - drug therapy; Quality of Life; Risedronate Sodium; Medicine; Risedronic acid; Perfusion; Paget disease; Zoledronic acid; Diphosphonic acid derivatives; Bisphosphonates; Comparative study
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa044241

This study compared a single intravenous infusion of zoledronic acid with daily oral risedronate in patients with Paget's disease. At six months, 96 percent of patients receiving zoledronic acid had a therapeutic response, as compared with 74 percent of patients given risedronate. Single-infusion zoledronate produces more rapid, complete, and sustained responses than does daily risedronate and may increase adherence to bisphosphonate therapy.
Single-infusion zoledronate produces more rapid, complete, and sustained responses than does daily risedronate and may increase adherence to bisphosphonate therapy.
Paget's disease of bone is characterized by a dramatic increase in bone turnover (both formation and resorption) at one or more sites. Measurement of biochemical markers of bone turnover is used to assess disease activity and monitor the response to therapy. About 2 percent of the U.S population older than 60 years of age have Paget's disease,
1
as do up to 6 or 7 percent of the elderly population in western Europe.
2
The bone pain, skeletal deformity, pathologic fractures, secondary arthritis, neurologic complications, and deafness that may accompany this disease contribute to substantial morbidity in the older population.
Bisphosphonate therapy . . .