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Treatment with Zoledronic Acid Ameliorates Negative Geometric Changes in the Proximal Femur following Acute Spinal Cord Injury

Calcified Tissue International volume 80, pages 316–322 (2007)Cite this article

Abstract

Acute spinal cord injury is associated with rapid bone loss and an increased risk of fracture. In this double-blind, randomized, placebo-controlled trial, 17 patients were followed for 1 year after administration of either 4 or 5 mg of zoledronic acid or placebo. Bone mineral density (BMD) and structural analyses of the proximal femur were performed using the hip structural analysis program at entry, 6 months, and 12 months. The 17 subjects completed 12 months of observation, nine receiving placebo and eight zoledronic acid. The placebo group showed a decrease in BMD, cross-sectional area, and section modulus and an increase in buckling ratio at each proximal femur site at 6 and 12 months. Six months after zoledronic acid, BMD, cross-sectional area, and section modulus increased at the femoral neck and intertrochanteric regions and buckling ratio decreased consistent with improved bone stability. However, at 12 months, the femoral narrow-neck values declined to baseline. In contrast to placebo, the intertrochanteric region and femur shaft were maintained at or near baseline through 12 months in the zoledronic acid-treated group. Urine N-telopeptide excretion was increased at baseline and declined in both the placebo and treatment groups during the 12 months of observation. We conclude that a single administration of zoledronic acid will ameliorate bone loss and maintain parameters of bone strength at the three proximal femur sites for 6 months and at the femur intertrochanteric and shaft sites for 12 months.

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Acknowledgment

We thank Dr. Peter Richardson, Head of Development at Novartis Pharmaceuticals, Japan, for his assistance in the initiation of the study and Dr. Uri Liberman, University of Tel Aviv, for editorial assistance. Funding for this work was provided by the National Space Biomedical Research Institute and Novartis Pharmaceuticals, Inc.

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Affiliations

  1. Department of Physical Medicine and Rehabilitation, Kennedy Krieger Institute, 707 North Broadway, Baltimore, MD, 21205, USA

    J. Shapiro

  2. National Rehabilitation Hospital, 102 Irving Street NW, Washington, DC, 20010, USA

    B. Smith & P. Ballard

  3. Department of Radiology, Johns Hopkins University Outpatient Center, 601 North Caroline Street, Suite 4233, Baltimore, MD, 21287, USA

    T. Beck & M. Dapthary

  4. Catholic University of America, 2344 Nebraska Avenue NW, Washington, DC, 20016, USA

    K. BrintzenhofeSzoc

  5. Novartis Pharmaceuticals, Inc., One Health Plaza, Building 122, East Hanover, NJ, 07936, USA

    J. Caminis

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  1. J. Shapiro
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  2. B. Smith
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  3. T. Beck
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Correspondence to J. Shapiro.

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Shapiro, J., Smith, B., Beck, T. et al. Treatment with Zoledronic Acid Ameliorates Negative Geometric Changes in the Proximal Femur following Acute Spinal Cord Injury. Calcif Tissue Int 80, 316–322 (2007). https://doi.org/10.1007/s00223-007-9012-6

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  • DOI: https://doi.org/10.1007/s00223-007-9012-6

Keywords

  • Bone loss
  • Spinal cord injury
  • Zoledronic acid
  • Dual-energy X-ray absorptiometry
  • Hip structural analysis