Assessment of renal toxicity and osteonecrosis of the jaws in patients receiving zoledronic acid for bone metastasis

Abstract

ZA showed to be safe with a low rate of reversible renal toxicity. Patients receiving BP should be monitored carefully for renal toxicity and ONJ, especially those with exposure to BP beyond 2 years.

Diagnosis and treatment of bone metastasis: comprehensive guideline of the Japanese Society of Medical Oncology, Japanese Orthopedic Association, Japanese Urological Association, and Japanese Society for Radiation Oncology

“…Multiplicity and longer duration (>2 years) increase the risk. 93 The median time to occurrence is 4.7–5.4 months. 94 95 The risk for acute renal failure increases in low creatinine clearance rates (CCR, <60 mL/min).…”

Renal toxicity and osteonecrosis of the jaw in cancer patients treated with bisphosphonates: a long-term retrospective analysis

“…Ali et al [23] found BP safe and well tolerated in 22 patients treated for a median of 3.6 years. In an other study, 57 patients were treated for a median of 34 months: grade 1 nephrotoxicity was reported in 12.2% of them [22] Bujanda et al [24] found an overall 9% incidence of nephrotoxicity in 67 patients analysed (18% in the group treated for [2 years).…”

“…The American Society of Clinical Oncology guidelines for BP in BC suggests treating patients for as long their performance status does not deteriorate [21], but there are still few data concerning their safety and efficacy in patients treated for more than 2 years [22][23][24]. Ali et al [23] found BP safe and well tolerated in 22 patients treated for a median of 3.6 years.…”

“…It was first diagnosed in February 2002, when attention was initially drawn to the problem; before this time it is possible that some asymptomatic cases may have been misdiagnosed. The real incidence of ONJ remains unknown yet [12,24,[26][27][28][29][30][31]. One of the largest study reported in the literature described 119 cases of ONJ: 26% occurred after pamidronate, 40.3% after zoledronic acid, 30.2% in patients treated with both drugs, and 2.5% in patients who had received alendronate due to osteoporosis [31].…”

Zoledronic acid for the treatment of appendicular osteosarcoma in a dog

“…The dog received 4 mg of zoledronic acid diluted in 100 ml of saline solution every 28 days in a slow intravenous infusion over 30 minutes. The dog had a complete blood cell count and a biochemical profile checked before each zoledronate infusion and a thorough oral examination and jaw radiographs every six months to rule out bisphosphonate‐induced bone necroses (Aguiar Bujanda and others 2007, Wilkinson and others 2007).…”