Acute Phase Reactions After Zoledronic Acid Infusion: Protective Role of 25-Hydroxyvitamin D and Previous Oral Bisphosphonate Therapy

Crotti, Chiara; Watts, Nelson B.; Santis, Maria De; Ceribelli, Angela; Fabbriciani, Gianluigi; Cavaciocchi, Francesca; Marasini, Bianca; Selmi, Carlo; Massarotti, Marco

doi:10.4158/ep161638.or

Cited by 26 publications

(19 citation statements)

References 23 publications

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“…(82,83) Adequate serum levels of vitamin D may be protective, (84) and providing acetaminophen to patients for a few days after the infusion can reduce the incidence of symptoms by around 50%, although it cannot completely eliminate the risk. APRs usually occur within the first 3 days after infusion and are most common in patients who have never taken bisphosphonates before and are undergoing infusion for the first time.…”

Section: Fundamental Recommendations and Rationalesmentioning

confidence: 99%

“…APRs usually occur within the first 3 days after infusion and are most common in patients who have never taken bisphosphonates before and are undergoing infusion for the first time. (82,83) Adequate serum levels of vitamin D may be protective, (84) and providing acetaminophen to patients for a few days after the infusion can reduce the incidence of symptoms by around 50%, although it cannot completely eliminate the risk. (82,83) APRs that occur in the hospital are particularly problematic because fever in the perioperative period can also signal infection-they therefore can trigger substantial diagnostic evaluation and potential overtreatment of a suspected infection.…”

Section: Recommendationmentioning

confidence: 99%

See 1 more Smart Citation

Secondary Fracture Prevention: Consensus Clinical Recommendations from a Multistakeholder Coalition

Conley

Adib²,

Adler

et al. 2019

Journal of Bone and Mineral Research

167

111

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Osteoporosis‐related fractures are undertreated, due in part to misinformation about recommended approaches to patient care and discrepancies among treatment guidelines. To help bridge this gap and improve patient outcomes, the American Society for Bone and Mineral Research assembled a multistakeholder coalition to develop clinical recommendations for the optimal prevention of secondary fracture among people aged 65 years and older with a hip or vertebral fracture. The coalition developed 13 recommendations (7 primary and 6 secondary) strongly supported by the empirical literature. The coalition recommends increased communication with patients regarding fracture risk, mortality and morbidity outcomes, and fracture risk reduction. Risk assessment (including fall history) should occur at regular intervals with referral to physical and/or occupational therapy as appropriate. Oral, intravenous, and subcutaneous pharmacotherapies are efficacious and can reduce risk of future fracture. Patients need education, however, about the benefits and risks of both treatment and not receiving treatment. Oral bisphosphonates alendronate and risedronate are first‐line options and are generally well tolerated; otherwise, intravenous zoledronic acid and subcutaneous denosumab can be considered. Anabolic agents are expensive but may be beneficial for selected patients at high risk. Optimal duration of pharmacotherapy is unknown but because the risk for second fractures is highest in the early post‐fracture period, prompt treatment is recommended. Adequate dietary or supplemental vitamin D and calcium intake should be assured. Individuals being treated for osteoporosis should be reevaluated for fracture risk routinely, including via patient education about osteoporosis and fractures and monitoring for adverse treatment effects. Patients should be strongly encouraged to avoid tobacco, consume alcohol in moderation at most, and engage in regular exercise and fall prevention strategies. Finally, referral to endocrinologists or other osteoporosis specialists may be warranted for individuals who experience repeated fracture or bone loss and those with complicating comorbidities (eg, hyperparathyroidism, chronic kidney disease). © 2019 American Society for Bone and Mineral Research.

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Section: Fundamental Recommendations and Rationalesmentioning

confidence: 99%

Section: Recommendationmentioning

confidence: 99%

Secondary Fracture Prevention: Consensus Clinical Recommendations from a Multistakeholder Coalition

Conley

Adib²,

Adler

et al. 2019

Journal of Bone and Mineral Research

167

111

View full text Add to dashboard Cite

show abstract

“…The risk of a flu-like reaction after an intravenous bisphosphonate infusion is substantial in treatment-naïve individuals and, in some studies, affected > 50% of individuals [10,11]. Strategies to reduce the risk of a flu-like reaction after IV bisphosphonates have variable success, and some groups may be more vulnerable than others.…”

Section: Careful Education Of Patients Receiving Intravenous Bisphospmentioning

confidence: 99%

Osteoporosis in the age of COVID-19

Girgis

Clifton‐Bligh

2020

Osteoporos Int

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As the world grapples with the crisis of COVID-19, established economies and healthcare systems have been brought to their knees. Tough decisions regarding redirection of resources away from the management of conditions deemed "nonessential" are being made. How can we balance urgent resourcing of our acute crisis while not abandoning the real need of patients with osteoporosis? This article offers a few practical solutions.

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“…It should be acknowledged, however, that > 50% of individuals after an intravenous bisphosphonate infusion face a flu-like reaction (fever, myalgias), which might complicate the diagnosis and be misunderstood as COVID-19 disease especially in hospitalized patients (18)(19). Furthermore, the pandemic of COVID-19 might pose obstacles on follow-up management of osteoporosis, so patients who already receive bisphosphonates should be encouraged to continue their current treatment, even nonsufficient, because of the significantly greater risk of new fractures in case of drug intermission (20)(21).…”

Section: Covid-19 and Osteoporosis Managementmentioning

confidence: 99%

The COVID-19 Pandemic as a threatening for bone health

2021

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The worldwide predominance of coronavirus disease 2019 (COVID-19) pandemic will have tremendous consequences on bone health of the general population and specifically to the bone mineral density of both young and elderly adolescents, due to sedentary lifestyle resulting from the prolonged and repeated lockdown. Scientific articles argue about the short and long term consequences on bone health resulting from the social isolation and the subsequent sedentary behaviors, whereas experts focus their scientific interest at guidelines for diagnosis, management and prevention of osteoporosis in the era of the COVID-19 pandemic

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Acute Phase Reactions After Zoledronic Acid Infusion: Protective Role of 25-Hydroxyvitamin D and Previous Oral Bisphosphonate Therapy

Cited by 26 publications

References 23 publications

Secondary Fracture Prevention: Consensus Clinical Recommendations from a Multistakeholder Coalition

Secondary Fracture Prevention: Consensus Clinical Recommendations from a Multistakeholder Coalition

Osteoporosis in the age of COVID-19

The COVID-19 Pandemic as a threatening for bone health

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