Clinical Safety and Efficacy of Zoledronic Acid in the Treatment of Osteoporosis: A Retrospective Study

Abstract

Background: Zoledronic acid and denosumab now a days represent the most potent antiresorptive agents for the prevention and treatment of osteoporosis. Although same effects on bone resorption, these agents have distinct mechanisms of action. The aim of this study was to evaluate and compare the clinical safety and efficacy of zoledronic acid and denosumab in the treatment of osteoporosis.
Methods: This retrospective study included 385 patients with osteoporosis treated at Dhaka Specialized Pain Management & Research Center Ltd., Bangladesh between January 2023 and December 2024. Patients were divided into two groups. In one group, 294 patients received intravenous zoledronic acid and in another group 91 patients received subcutaneous denosumab. All patients were routinely followed up for up to 12 months. These patients were also monitored for drug-related adverse effects and pain relief after drug administration.
Results: In this study, the mean age of the patients was 57.1±11.8 and most of the patients were female (76.1%). The mean BMI was 23.5±3.1 kg/m2. The baseline BMD in spine T score found -2.51±1.31. The baseline VAS scores were 7.9 ± 1.1 and 7.1 ± 1.3, in zoledronic acid and denosumab group, respectively. After 1 year, the reduction in pain was statistically significant in both groups (p < 0.001), but pain relief was more pronounced in the zoledronic acid group. Both groups experienced mild and self-limiting adverse effects. Flu-like symptoms like fever (95%), myalgia (60%), and headache (5%) were more common in the zoledronic
acid group.
Conclusion: Zoledronic acid is a safe and effective treatment agent for osteoporosis and may offer better pain control compared to denosumab.