Reduced Schedule of Zometa® May Decrease the Incidence of Osteonecrosis of the Jaw
Researchers from Italy have reported that monthly treatment with Zometa (zoledronic acid) followed by treatment every 3 months can reduce the incidence of osteonecrosis of the jaw compared to continued monthly dosing in patients with multiple myeloma. The details of this study appeared in the July, 2007 issue of Leukemia.
Bisphosphonates are approved for the treatment of cancer-related hypercalcemia and for the prevention of bone complications from multiple myeloma and solid tumors. Osteonecrosis of the jaw has recently been reported as a complication of bisphosphonate therapy. Osteonecrosis is dead bone caused by interruption of blood supply. The original reports involved the use of Zometa, but cases have now been reported following the use of Aredia® (pamidronate). The reported incidence of osteonecrosis ranges from 6% to 13% of patients treated with Zometa. Researchers from Greece have reported that the most important risk factor for development of osteonecrosis of the jaw is time of exposure.
These authors performed a retrospective review of 106 patients with multiple myeloma treated with Zometa. Fifty-one percent received monthly administration of Zometa and 55 were treated with monthly Zometa for the first year and every 3 months thereafter. There were 6 cases of osteonecrosis in the group receiving a continued monthly schedule and 1 in the group that received Zometa every 3 months after the first year. The incidence of osteonecrosis of the jaw was 9.1 per 100 patient years for the continuous monthly schedule and 1.6 for the every 3 month schedule. There were no apparent differences in therapeutic efficacy (skeletal-related events) between the two groups.
Comments: These data are compatible with previous observations that osteonecrosis of the jaw is dependent on the duration of drug exposure. These data would suggest that decreasing the dosing interval of Zometa can be performed without loss of efficacy.
Reference: Corso A, Varettoni M, Zappasodi, et al. A different schedule of zoledronic acid can reduce the risk of osteonecrosis of the jaw in patients with multiple myeloma. Leukemia. 2007; 21:1545-1548.
Related News:
Risk Factors for Osteonecrosis of the Jaw from Bisphosphonates Defined (12/02/2005)
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