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dc.contributor.author Reid, Ian R
dc.contributor.author Green, Jonathan R
dc.contributor.author Lyles, Kenneth W
dc.contributor.author Reid, David M
dc.contributor.author Trechsel, Ulrich
dc.contributor.author Hosking, David J
dc.contributor.author Black, Dennis M
dc.contributor.author Cummings, Steven R
dc.contributor.author Russell, R Graham G
dc.contributor.author Eriksen, Erik F
dc.date.accessioned 2020-12-09T01:30:27Z
dc.date.available 2020-12-09T01:30:27Z
dc.date.issued 2020-8
dc.identifier.issn 8756-3282
dc.identifier.uri http://hdl.handle.net/2292/53984
dc.description.abstract Zoledronate is the most potent and most long-acting bisphosphonate in clinical use, and is administered as an intravenous infusion. Its major uses are in osteoporosis, Paget's disease, and in myeloma and cancers to reduce adverse skeletal related events (SREs). In benign disease, it is a first- or second-line treatment for osteoporosis, achieving anti-fracture efficacy comparable to that of the RANKL blocker, denosumab, over 3 years, and it reduces fracture risk in osteopenic older women. It is the preferred treatment for Paget's disease, achieving higher rates of remissions which are much more prolonged than with any other agent. Some trials have suggested that it reduces mortality, cardiovascular disease and cancer, but these findings are not consistent across all studies. It is nephrotoxic, so should not be given to those with significant renal impairment, and, like other potent anti-resorptive agents, can cause hypocalcemia in patients with severe vitamin D deficiency, which should be corrected before administration. Its most common adverse effect is the acute phase response, seen in 30-40% of patients after their first dose, and much less commonly subsequently. Clinical trials in osteoporosis have not demonstrated increases in osteonecrosis of the jaw or in atypical femoral fractures. Observational databases are currently inadequate to determine whether these problems are increased in zoledronate users. Now available as a generic, zoledronate is a cost-effective agent for fracture prevention and for management of Paget's disease, but wider provision of infusion facilities is important to increase patient access. There is a need to further explore its potential for reducing cancer, cardiovascular disease and mortality, since these effects could be substantially more important than its skeletal actions.
dc.format.medium Print-Electronic
dc.language eng
dc.relation.ispartofseries Bone
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher.
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm
dc.subject 1103 Clinical Sciences
dc.subject Clinical
dc.subject Clinical Medicine and Science
dc.subject Prevention
dc.subject Clinical Trials and Supportive Activities
dc.subject Cancer
dc.subject Aging
dc.subject Osteoporosis
dc.subject Clinical Research
dc.subject Cancer
dc.subject Musculoskeletal
dc.subject 6.1 Pharmaceuticals
dc.subject 5.1 Pharmaceuticals
dc.subject 06 Biological Sciences
dc.subject 09 Engineering
dc.subject 11 Medical and Health Sciences
dc.title Zoledronate.
dc.type Journal Article
dc.identifier.doi 10.1016/j.bone.2020.115390
pubs.begin-page 115390
pubs.volume 137
dc.date.updated 2020-11-19T02:34:09Z
dc.rights.holder Copyright: The author en
pubs.publication-status Published
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Journal Article
pubs.elements-id 801770
dc.identifier.eissn 1873-2763

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