Prolonged Effect of Zoledronic Acid on Bone Mineral Density and Turnover in HIV-Infected Adults on Tenofovir: A Randomized, Open-Label Study

Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research
Andrew CarrZEST Study Investigators

Abstract

Zoledronic acid (ZOL) 5 mg annually was more effective than tenofovir disoproxil fumarate (TDF) switching at increasing bone mineral density (BMD) over 24 months in HIV-infected, osteopenic adults. To determine whether the effects of ZOL would persist without further infusions, we compared changes in left hip and spine BMD over 36 months in participants randomized to ZOL 5 mg at baseline and month 12 (and to continue TDF) or to switch TDF (without receiving ZOL). We also compared changes in the plasma bone turnover markers (BTMs) C-terminal telopeptide of type 1 collagen (CTX; bone resorption), and procollagen type 1 N propeptide (P1NP; bone formation) and determined whether CTX and P1NP changes at month 3 predicted BMD changes at month 36. Changes were compared in the per-protocol populations, which included 32 (74%) of 43 participants randomized to ZOL and 37 (88%) of 42 participants who switched TDF. Despite not receiving ZOL after month 12, mean hip and spine BMD change from baseline were stable and remained greater with ZOL at month 36 than with TDF switching (spine: 7.5% versus 2.7%, mean difference 4.7%, p < 0.001; hip: 5.5% versus 1.5%, mean difference 4.0%, p < 0.001). CTX and P1NP levels declined in both groups but si...Continue Reading

References

Jul 3, 2008·The Journal of Clinical Endocrinology and Metabolism·Virginia A TriantSteven K Grinspoon
Sep 11, 2010·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Hans-Jürgen StellbrinkUNKNOWN ASSERT Study Group
Mar 16, 2012·The Journal of Clinical Endocrinology and Metabolism·Mark J BollandIan R Reid
Jun 6, 2012·Nature Reviews. Rheumatology·Kim Naylor, Richard Eastell
Jan 28, 2014·HIV Medicine·M BlochUNKNOWN TROP (Switch from Tenofovir to Raltegravir for Low Bone Density) study team
Mar 23, 2017·Journal of Bone Metabolism·Ji-Hye ByunYong-Chan Ha
Sep 13, 2017·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Andrew GreyIan R Reid

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Citations

Jan 19, 2020·Current HIV/AIDS Reports·Stephanie ShiauMichael T Yin
Apr 13, 2021·Current Opinion in HIV and AIDS·Elena Alvarez-Barco, Patrick W G Mallon
Sep 4, 2021·Endocrine Reviews·Peter R EbelingFrances Milat

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