Advantages of zoledronic acid in the therapy of osteoporosis in real clinical practice

Abstract

Introduction. The development of osteoporosis (OP) increases healthcare costs and often leads to disability of patients. In this regard, the search for ways to improve the effectiveness of OP treatment is very relevant. Today, there is a wide range of drugs for the effective correction of bone metabolism. However, low patient compliance in real clinical practice significantly reduces the effectiveness of therapy.Aim. To study the effect of patient compliance on the effectiveness of Zoledronic acid and Denosumab in OP in real clinical practice.Materials and methods. Study design: a retrospective analysis of outpatient records of 300 patients with OP, who were prescribed Zoledronic acid or Denosumab in 2019, with a prospective analysis of adherence to therapy for 3 years.Results. It was revealed that 12% of patients did not start pathogenetic therapy for OP (control group). 88% (264 patients) started pathogenetic therapy: of these, 22.33% (67 patients) preferred therapy with Denosumab; 65.67% (197 patients) – Zoledronic acid. After 1 year, therapy with Denosumab 19.4%, Zoledronic acid – 19.29% was discontinued. More than 1 month late with the next injection of the drug: Denosumab – 25.37%, Zoledronic acid – 16.24% of patients. Only 55.22% who received Denosumab and 64.47% who received Zoledronic acid fully complied with the recommendations. Most often, a violation of the schedule of drug administration was observed in patients over 75 years of age, alone, with impaired cognitive status. Discontinuation of therapy with Denosumab or violation of the schedule of its administration led to an increase in the level of bone resorption (C-telopeptide type I collagen (CTX-1)). During therapy with Zoledronic acid, there was no increase in CTX-1. In addition, the cost of course treatment with Zoledronic acid is 2–3 times less than with Denosumab.Conclusion. In real clinical practice, zoledronic acid has clinical and pharmacoeconomic advantages, especially in patients with expected low adherence to OP therapy.