Comparison of two different strategies of treatment with zoledronate in HIV‐infected patients with low bone mineral density: single dose versus two doses in 2 years. Issue 7 (6th May 2015)

• Record Type: Journal Article
• Authors: Negredo, E; Bonjoch, A; Pérez‐Álvarez, N; Ornelas, A; Puig, J; Herrero, C; Estany, C; del Río, L; di Gregorio, S; Echeverría, P; Clotet, B
• Is Part Of: HIV medicine. Volume 16:Issue 7(2015:Aug.)
• Page Start: 441
• Page End: 448
• Publication Date: 2015-05-06
• Subjects: HIV infections -- Treatment -- Periodicals; HIV-positive persons -- Periodicals; HIV infections -- Treatment -- Decision making -- Periodicals; 616.9792
• DOI: 10.1111/hiv.12260
• Languages: English
• ISSNs: 1464-2662

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="hiv12260-sec-0001" sec-type="section"> <title>Objectives</title> <p>Given the need for easily managed treatment of osteoporosis in HIV‐infected patients, we evaluated the efficacy and tolerability of two doses of zoledronate, by comparing three groups of patients: those with annual administration, those with biennial administration (one dose in 2 years) and a control group with no administration of zoledronate.</p> </sec> <sec id="hiv12260-sec-0002" sec-type="section"> <title>Methods</title> <p>We randomized (2:1) 31 patients on antiretroviral therapy with low bone mineral density (BMD) to zoledronate (5 mg administered intravenously; 21 patients) plus diet counselling and to a control group (diet counselling; 10 patients). At week 48, patients treated with zoledronate were randomized again to receive a second dose (two‐dose group; <italic>n</italic> = 12) or to continue with diet counselling only (single‐dose group; <italic>n</italic> = 9). Changes in lumbar spine and hip BMD and bone turnover markers were compared.</p> </sec> <sec id="hiv12260-sec-0003" sec-type="section"> <title>Results</title> <p>The median percentage change from baseline to week 96 in L1−L4 BMD was −1.74% [interquartile range (IQR) −2.56, 3.60%], 7.90% (IQR 4.20, 16.57%) and 5.22% (IQR 2.02, 7.28%) in the control, two‐dose and single‐dose groups, respectively (<italic>P</italic> < 0.01, control <italic>vs.</italic> two doses; <italic>P</italic> = 0.02, control <italic>vs.</italic> single dose; <italic>P</italic> = 0.18, two doses <italic>vs.</italic> single dose). Hip BMD changed by a median of 2.12% (IQR −0.12, 3.08%), 5.16% (IQR 3.06, 6.74%) and 4.47% (IQR 1, 5.58%), respectively (<italic>P</italic> = 0.04, control <italic>vs.</italic> two doses; <italic>P</italic> = 0.34, two doses <italic>vs.</italic> single dose). No differences between the two‐dose and single‐dose groups were detected in bone markers at week 96.</p> </sec> <sec id="hiv12260-sec-0004" sec-type="section"> <title>Conclusions</title> <p>The benefits for BMD of a single dose of zoledronate in 2 years may be comparable to those obtained with two doses of the drug after 96 weeks, although this study is insufficiently powered to exclude a real difference. Future studies should explore whether biennial administration of zoledronate is a useful alternative in the treatment of osteoporosis in HIV‐infected patients.</p> </sec> </abstract>