Osteoporosis in thalassemia patients and use of zoledronic acid in the treatment of osteoporosis

ABSTRACT Osteoporosis in Thalassemia Patients and Use of Zoledronic Acid in the Treatment of Osteoporosis Osteoporosis remains as a prominent cause of morbidity, even in well-transfused and iron- chelated patients with thalassemia major. Impaired osteoblastic function and increased osteoclastic activities are among the possible contributory mechanisms of osteoporosis seen in thalassemia major. The aim of this study was to investigate the effect of zoledronic acid on the osteoporosis of thalassemia. The effects of treatment on biochemical markers of bone remodeling and bone mineral density (BMD) were studied in 38 patients with beta-thalassemia and osteoporosis. Thalassemic patients were randomly divided to receive either zoledronic acid i.v. at a dose of 4 mg every 6 months over 12 months or calcitriol 0.25 meg/day. All patients received 1000 mg of elemental calcium. Insulin-like growth factor I (IGF-I) levels which were significantly lower in zoledronic acid and calcitriol groups compared to controls at baseline (p<0.001), increased significantly at the end of treatment in both groups (p=0.04 and p=0.006, respectively). At the end of the study, the lumbar spine and femoral neck BMD had increased significantly in the zoledronic acid group (p=0.02 and p= 0.01, respectively) whereas in the calcitriol group neither of the measurements changed significantly (p=0.3 and p=0.1, respectively). No relevant side effects were recorded during the study period. These data suggest that in patients with thalassemia-induced osteoporosis, administration of zoledronic acid is an effective treatment Key words: IGF-I, osteoporosis, thalassemia, zoledronic asit. vn