Effect of early treatment with zoledronic acid on prevention of bone loss in patients with acute spinal cord injury: a randomized controlled trial.

Abstract

Randomized controlled trial. To determine the effect of zoledronic acid on bone loss in people with acute spinal cord injury (SCI) SETTINGS: Sawai Man Singh Medical College, India. Sixty patients with acute SCI were randomized to receive either standard treatment alone or standard treatment with zoledronic acid within 3 months after injury. Areal bone mineral density (aBMD) was measured at the hip using dual-energy X-ray absorptiometry (DXA) at baseline 3, 6, and 12 months. Significant differences in aBMD were found between the standard treatment alone and standard treatment plus zoledronic acid group at the femoral neck (-0.13; 95% CI, -0.18 to -0.09, p < 0.0001), and total hip (-0.16; 95% CI, -0.19 to -0.12, p < 0.0001), respectively, at 1 year and bone loss was reduced in the zoledronic acid treated group as compared to the standard treatment group. Significant differences in aBMD between the groups at 6 months post infusion was also observed at these sites. [Femoral neck -0.08; 95% CI, -0.12 to -0.03; p = 0.002 and total hip -0.12; 95% CI, -0.15 to -0.08; p < 0.0001] CONCLUSION: A zoledronic acid 5 mg infusion given within 3 month significantly reduces bone loss at the hip after 6 months post infusion in patients with acute SCI.