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Post-menopausal women taking less than the standard 5 mg dose of zoledronate did just as well on bone density and turnover measures, according to a randomized trial.
Grey A, Bolland M, Mihov B et al., Duration of anti-resorptive effects of low dose zoledronate in osteopenic postmenopausal women: A randomized, placebo-controlled trial.J Bone Miner Res (2013) [Epub ahead of print] PMID: 23761303
A single, lower dose of intravenous zoledronate (Reclast, Zometa) increases bone mineral density (BMD) in the hips and spine and decreases biochemical markers of bone turnover among post-menopausal women, persisting for at least two years, say researchers in New Zealand.
The University of Auckland group conducted a two-year double-blind randomized trial, assigning 180 osteopenic postmenopausal women to a single baseline dose of IV zoledronate – either 1 mg, 2.5 mg, or 5 mg (the usual dose) -- or a placebo. The primary endpoint was a change in BMD at the lumbar spine.
After two years,each of the three zoledronate groups showed significant changes compared with results for placebo. The greatest increase (5.5%) occurred among those taking 2.5 mg.
BMD of the total hip was significantly greater in each of the zoledronate dose groups than in the placebo group. Decreases in biochemical bone turnover markers were similar in the medium and higher dose groups throughout the trial.
Does intermittent, lower dosing of zoledronate reduce the risk of fractures, particularly at the 2.5 mg level? The researchers say this justifies investigation.