DATA-HD Extension Trial: Zoledronic Acid Maintains Improved BMD in Postmenopausal Osteoporosis
A single dose of zoledronic acid can maintain Improvement in bone mineral density (BMD) that was previously achieved with combination teriparatide/denosumab therapy, followed by denosumab monotherapy, according to findings from the Denosumab and Teriparatide Study (DATA-HD) extension trial presented at the American Society for Bone and Mineral Research 2019 Annual Meeting.
Findings from the DATA-HD study showed that denosumab—when used in combination with high-dose teriparatide and then afterward as monotherapy—significantly increased BMD at all anatomic sites among postmenopausal women aged 52 to 82 years. The participants had received treatment with either teriparatide, 20 µg, or teriparatide, 40 µg, daily for 9 months. The participants received treatment with denosumab, 60 mg, after an initial 3 months of teriparatide and then again at 9 months when teriparatide was discontinued.
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To evaluate whether zoledronic acid would allow patients to retain improved BMD, Joy Tsai, MD, from Massachusetts General Hospital, and colleagues invited all participants to participate in the extension trial.
Of all the participants, 53 received a single intravenous dose of zoledronic acid, 5 mg, 5 to 7 months after the prior denosumab injection.
Overall, 26 participants who had received treatment with teriparatide, 20 mcg, and 27 participants who had received treatment with teriparatide, 40 mcg, had increased BMD. The BMD was maintained similarly in both treatment groups and at all sites.
The authors noted that timing of infusion of zoledronic acid affected the BMD changes during months 15 to 27.
The participants who received the infusion less than 26 weeks after the denosumab injection had the greatest decrease in femoral neck and total hip BMD; the mean BMD change was -1.5% at the femoral neck and -3.0% at the total hip. The pattern was not similar at the spine and radius.
“The distinct pattern of hip BMD changes among those who received [zoledronic acid fewer than] 26 weeks after the [denosumab] injection suggests that the timing of [zoledronic acid] administration may influence efficacy,” the authors concluded.
—Colleen Murphy
Reference:
Tsai J, David N, Sassana G, Leder B. Zoledronic acid maintains bone mineral density after denosumab administration (DATA-HD extension) [Abstract #1048]. Presented at: American Society for Bone and Mineral Research 2019 Annual Meeting; September 21, 2019; Orlando, FL.