ACUTE PHASE REACTIONS AFTER ZOLEDRONIC ACID INFUSION: PROTECTIVE ROLE OF 25-OH VITAMIN D AND PREVIOUS ORAL BISPHOSPHONATE THERAPY.

ACUTE PHASE REACTIONS AFTER ZOLEDRONIC ACID INFUSION: PROTECTIVE ROLE OF 25-OH VITAMIN D AND PREVIOUS ORAL BISPHOSPHONATE THERAPY.

Endocr Pract. 2018 Mar 02;:

Authors: Crotti C, Watts NB, De Santis M, Ceribelli A, Fabbriciani G, Cavaciocchi F, Marasini B, Selmi C, Massarotti M

Abstract
PURPOSE: The most common adverse reaction to zoledronic acid (ZOL) infusion is the acutephase reaction (APR), characterized by transient, usually mild, flu-like symptoms. Previous treatment with oral aminobisphosphonates (BPs) was reported as an independent protective factor for APR, and an association between APR and 25-hydroxyvitamin D (25[OH]D) levels in BP-naïve patients treated with ZOL was identified. The aim of our study was to confirm this association and to see if the association was different in patients previously treated with oral BPs compared with BP-naïve patients, and to investigate the role of 25(OH)D for the time of APR onset.
METHODS: We included 153 consecutive patients with postmenopausal osteoporosis undergoing their first ZOL infusion. Sixty-eight had been previously treated with oral BPs. Clinical, demographic and serological data were recorded.
RESULTS: 25(OH)D levels were significantly lower in patients experiencing APR compared to patients without APR (26.3±12.7 vs 37.0±13.5ng/mL, respectively; p<0.0001). Patients with 25(OH)D <30ng/mL had a significantly higher risk of APR (odds ratio [OR] 4.2 [95% confidence interval [CI] 2.1-8.2]) occurring in 65%. APR was significantly less frequent in patients previously treated with oral BPs than in BP-naïve subjects (33.8% [23/68] vs 52.9% [45/85], p=0.018), but only a weak association remained after correction for 25(OH)D (OR 0.5, 95% CI 0.3-1.1, p=0.08).
CONCLUSIONS: Higher baseline 25(OH)D levels appear to be protective for APR post-ZOL infusion. The role of previous treatment with oral BPs as an independent protective factor for APR should be evaluated in a larger cohort.
ABBREVIATIONS: ZOL = zoledronic acid; APR = acute-phase reaction; BPS = amino-bisphosphonates; 25[OH]D = 25-hydroxyvitamin D; OR = odds ratio; CI = confidence interval; OP = osteoporosis; PTH = parathyroid hormone; ROC = receiver operating characteristic.

PMID: 29498910 [PubMed - as supplied by publisher]

http://ift.tt/2tdId05