Zoledronic acid in osteoporosis secondary to mastocytosis.

Abstract

BACKGROUND:

Osteoporosis is the prevalent manifestation of bone involvement in patients with systemic mastocytosis. Mastocytosis-related osteoporosis is characterized by both absolute and relative prevalence of osteoclastic activity, consistent with the positive results reported in small series of patients with antiresorptive drugs, such as bisphosphonates. The aim of this study is to investigate the efficacy of zoledronic acid in patients with mastocytosis-related osteoporosis.

METHODS:

Twenty-five patients with osteoporosis secondary to indolent systemic mastocytosis were given a single intravenous infusion of 5 mg zoledronic acid dissolved in 100 mL of 0.9% saline over 60 minutes.

RESULTS:

After 1 year, the mean increase in bone mineral density was 6.0% ± 4.4% at the spine and 2.4% ± 3.2% at the total hip. Serum levels of bone turnover markers decreased versus baseline: bone alkaline phosphatase -34% and -35%, and C-terminal telopeptide -68% and -56% at 6 and 12 months, respectively. None of the patients reported new fractures during the year of follow-up. In all the first 20 treated patients, a transitory acute phase response was observed, but this was prevented in 4 of 5 subsequent patients in whom acetaminophen was given systematically during the 3 days post-infusion.

CONCLUSIONS:

A single 5 mg zoledronic acid intravenous infusion in patients with osteoporosis secondary to indolent systemic mastocytosis is associated with significant increases in spine and hip bone mineral density and decreases of bone turnover markers over at least 1 year. Yearly zoledronic acid might represent a therapeutic option for indolent systemic mastocytosis-associated osteoporosis.

• Authors: Maurizio Rossini, Roberta Zanotti, Ombretta Viapiana, Gaia Tripi, Luca Idolazzi, Marta Biondan, Giovanni Orsolini, Patrizia Bonadonna, Silvano Adami, Davide Gatti
• Journal: The American journal of medicine (Am J Med) Vol. 127 Issue 11 Pg. 1127.e1-1127.e4 (Nov 2014) ISSN: 1555-7162 [Electronic] United States
• PMID: 24954632 (Publication Type: Journal Article)
• Copyright: Copyright © 2014 Elsevier Inc. All rights reserved.

Chemical References

• Bone Density Conservation Agents
• Collagen Type I
• Diphosphonates
• Imidazoles
• Peptides
• collagen type I trimeric cross-linked peptide
• Zoledronic Acid
• Alkaline Phosphatase

Topics

• Absorptiometry, Photon
• Adult
• Aged
• Aged, 80 and over
• Alkaline Phosphatase (blood)
• Bone Density
• Bone Density Conservation Agents (therapeutic use)
• Collagen Type I (blood)
• Diphosphonates (therapeutic use)
• Female
• Follow-Up Studies
• Humans
• Imidazoles (therapeutic use)
• Infusions, Intravenous
• Male
• Mastocytosis, Systemic (complications)
• Middle Aged
• Osteoporosis (drug therapy, etiology)
• Peptides (blood)
• Zoledronic Acid