Acute phase reactions after zoledronic acid infusion: Protective role of 25-hydroxyvitamin D and previous oral bisphosphonate therapy

Chiara Crotti, Nelson B. Watts, Maria De Santis, Angela Ceribelli, Gianluigi Fabbriciani, Francesca Cavaciocchi, Bianca Marasini, Carlo Selmi, Marco Massarotti

Research output: Contribution to journalArticle

Abstract

Objective: The most common adverse reaction to zoledronic acid (ZOL) infusion is the acute phase reaction (APR), characterized by transient, usually mild, flu-like symptoms. Previous treatment with oral amino-bisphosphonates (BPs) was reported as an independent protective factor for APR, and an association between APR and 25-hydroxyvitamin D (25(OH)D) levels in BP-naïve patients treated with ZOL was identified. The aims of our study were to confirm this association and to see if it was different in patients previously treated with oral BPs compared with BP-naïve patients and to investigate the role of 25(OH)D for the time of APR onset. Methods: We included 153 consecutive patients with postmenopausal osteoporosis undergoing their first ZOL infusion. Sixty-eight had been previously treated with oral BPs. Clinical, demographic, and serologic data were recorded. Results: 25(OH)D levels were significantly lower in patients experiencing APR compared to patients without APR (26.3 ± 12.7 vs. 37.0 ± 13.5 ng/mL, respectively; P<.0001). Patients with 25(OH)D <30 ng/mL had a significantly higher risk of APR (odds ratio [OR] 4.2 [95% confidence interval [CI] 2.1-8.2]) occurring in 65%. APR was significantly less frequent in patients previously treated with oral BPs than in BP-naïve subjects (33.8% [23/68] vs 52.9% [45/85], P = .018), but only a weak association remained after correction for 25(OH)D (OR 0.5, 95% CI 0.3-1.1, P = .08). Conclusion: Higher baseline 25(OH)D levels appear to be protective for APR post-ZOL infusion. The role of previous treatment with oral BPs as an independent protective factor for APR should be evaluated in a larger cohort.

Original languageEnglish
Pages (from-to)405-410
Number of pages6
JournalEndocrine Practice
Volume24
Issue number5
DOIs
Publication statusPublished - May 1 2018

Fingerprint

zoledronic acid
Acute-Phase Reaction
Diphosphonates
Therapeutics
Odds Ratio
25-hydroxyvitamin D
Confidence Intervals
Postmenopausal Osteoporosis

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Acute phase reactions after zoledronic acid infusion : Protective role of 25-hydroxyvitamin D and previous oral bisphosphonate therapy. / Crotti, Chiara; Watts, Nelson B.; De Santis, Maria; Ceribelli, Angela; Fabbriciani, Gianluigi; Cavaciocchi, Francesca; Marasini, Bianca; Selmi, Carlo; Massarotti, Marco.

In: Endocrine Practice, Vol. 24, No. 5, 01.05.2018, p. 405-410.

Research output: Contribution to journalArticle

Crotti, Chiara ; Watts, Nelson B. ; De Santis, Maria ; Ceribelli, Angela ; Fabbriciani, Gianluigi ; Cavaciocchi, Francesca ; Marasini, Bianca ; Selmi, Carlo ; Massarotti, Marco. / Acute phase reactions after zoledronic acid infusion : Protective role of 25-hydroxyvitamin D and previous oral bisphosphonate therapy. In: Endocrine Practice. 2018 ; Vol. 24, No. 5. pp. 405-410.
@article{ca1a9a9ca05d459bb82be3982abb63c1,
title = "Acute phase reactions after zoledronic acid infusion: Protective role of 25-hydroxyvitamin D and previous oral bisphosphonate therapy",
abstract = "Objective: The most common adverse reaction to zoledronic acid (ZOL) infusion is the acute phase reaction (APR), characterized by transient, usually mild, flu-like symptoms. Previous treatment with oral amino-bisphosphonates (BPs) was reported as an independent protective factor for APR, and an association between APR and 25-hydroxyvitamin D (25(OH)D) levels in BP-na{\"i}ve patients treated with ZOL was identified. The aims of our study were to confirm this association and to see if it was different in patients previously treated with oral BPs compared with BP-na{\"i}ve patients and to investigate the role of 25(OH)D for the time of APR onset. Methods: We included 153 consecutive patients with postmenopausal osteoporosis undergoing their first ZOL infusion. Sixty-eight had been previously treated with oral BPs. Clinical, demographic, and serologic data were recorded. Results: 25(OH)D levels were significantly lower in patients experiencing APR compared to patients without APR (26.3 ± 12.7 vs. 37.0 ± 13.5 ng/mL, respectively; P<.0001). Patients with 25(OH)D <30 ng/mL had a significantly higher risk of APR (odds ratio [OR] 4.2 [95{\%} confidence interval [CI] 2.1-8.2]) occurring in 65{\%}. APR was significantly less frequent in patients previously treated with oral BPs than in BP-na{\"i}ve subjects (33.8{\%} [23/68] vs 52.9{\%} [45/85], P = .018), but only a weak association remained after correction for 25(OH)D (OR 0.5, 95{\%} CI 0.3-1.1, P = .08). Conclusion: Higher baseline 25(OH)D levels appear to be protective for APR post-ZOL infusion. The role of previous treatment with oral BPs as an independent protective factor for APR should be evaluated in a larger cohort.",
author = "Chiara Crotti and Watts, {Nelson B.} and {De Santis}, Maria and Angela Ceribelli and Gianluigi Fabbriciani and Francesca Cavaciocchi and Bianca Marasini and Carlo Selmi and Marco Massarotti",
year = "2018",
month = "5",
day = "1",
doi = "10.4158/EP161638.OR",
language = "English",
volume = "24",
pages = "405--410",
journal = "Endocrine Practice",
issn = "1530-891X",
publisher = "American Association of Clinical Endocrinology",
number = "5",

}

TY - JOUR

T1 - Acute phase reactions after zoledronic acid infusion

T2 - Protective role of 25-hydroxyvitamin D and previous oral bisphosphonate therapy

AU - Crotti, Chiara

AU - Watts, Nelson B.

AU - De Santis, Maria

AU - Ceribelli, Angela

AU - Fabbriciani, Gianluigi

AU - Cavaciocchi, Francesca

AU - Marasini, Bianca

AU - Selmi, Carlo

AU - Massarotti, Marco

PY - 2018/5/1

Y1 - 2018/5/1

N2 - Objective: The most common adverse reaction to zoledronic acid (ZOL) infusion is the acute phase reaction (APR), characterized by transient, usually mild, flu-like symptoms. Previous treatment with oral amino-bisphosphonates (BPs) was reported as an independent protective factor for APR, and an association between APR and 25-hydroxyvitamin D (25(OH)D) levels in BP-naïve patients treated with ZOL was identified. The aims of our study were to confirm this association and to see if it was different in patients previously treated with oral BPs compared with BP-naïve patients and to investigate the role of 25(OH)D for the time of APR onset. Methods: We included 153 consecutive patients with postmenopausal osteoporosis undergoing their first ZOL infusion. Sixty-eight had been previously treated with oral BPs. Clinical, demographic, and serologic data were recorded. Results: 25(OH)D levels were significantly lower in patients experiencing APR compared to patients without APR (26.3 ± 12.7 vs. 37.0 ± 13.5 ng/mL, respectively; P<.0001). Patients with 25(OH)D <30 ng/mL had a significantly higher risk of APR (odds ratio [OR] 4.2 [95% confidence interval [CI] 2.1-8.2]) occurring in 65%. APR was significantly less frequent in patients previously treated with oral BPs than in BP-naïve subjects (33.8% [23/68] vs 52.9% [45/85], P = .018), but only a weak association remained after correction for 25(OH)D (OR 0.5, 95% CI 0.3-1.1, P = .08). Conclusion: Higher baseline 25(OH)D levels appear to be protective for APR post-ZOL infusion. The role of previous treatment with oral BPs as an independent protective factor for APR should be evaluated in a larger cohort.

AB - Objective: The most common adverse reaction to zoledronic acid (ZOL) infusion is the acute phase reaction (APR), characterized by transient, usually mild, flu-like symptoms. Previous treatment with oral amino-bisphosphonates (BPs) was reported as an independent protective factor for APR, and an association between APR and 25-hydroxyvitamin D (25(OH)D) levels in BP-naïve patients treated with ZOL was identified. The aims of our study were to confirm this association and to see if it was different in patients previously treated with oral BPs compared with BP-naïve patients and to investigate the role of 25(OH)D for the time of APR onset. Methods: We included 153 consecutive patients with postmenopausal osteoporosis undergoing their first ZOL infusion. Sixty-eight had been previously treated with oral BPs. Clinical, demographic, and serologic data were recorded. Results: 25(OH)D levels were significantly lower in patients experiencing APR compared to patients without APR (26.3 ± 12.7 vs. 37.0 ± 13.5 ng/mL, respectively; P<.0001). Patients with 25(OH)D <30 ng/mL had a significantly higher risk of APR (odds ratio [OR] 4.2 [95% confidence interval [CI] 2.1-8.2]) occurring in 65%. APR was significantly less frequent in patients previously treated with oral BPs than in BP-naïve subjects (33.8% [23/68] vs 52.9% [45/85], P = .018), but only a weak association remained after correction for 25(OH)D (OR 0.5, 95% CI 0.3-1.1, P = .08). Conclusion: Higher baseline 25(OH)D levels appear to be protective for APR post-ZOL infusion. The role of previous treatment with oral BPs as an independent protective factor for APR should be evaluated in a larger cohort.

UR - http://www.scopus.com/inward/record.url?scp=85047947832&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85047947832&partnerID=8YFLogxK

U2 - 10.4158/EP161638.OR

DO - 10.4158/EP161638.OR

M3 - Article

C2 - 29498910

AN - SCOPUS:85047947832

VL - 24

SP - 405

EP - 410

JO - Endocrine Practice

JF - Endocrine Practice

SN - 1530-891X

IS - 5

ER -