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Zoledronic acid does not slow spinal radiographic progression of osteoarthritis in postmenopausal women with osteoporosis and radiographic osteoarthritis


Host, LV and Keen, HI and Laslett, LL and Black, DM and Jones, G, Zoledronic acid does not slow spinal radiographic progression of osteoarthritis in postmenopausal women with osteoporosis and radiographic osteoarthritis, Therapeutic Advances in Musculoskeletal Disease, 14 Article 1759720X221081652. ISSN 1759-720X (2022) [Refereed Article]

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The Author(s) 2022. This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) License ( This license allows re-users to distribute, remix, adapt, and build upon the material in any medium or format, so long as attribution is given to the creator. The license allows for commercial use.

DOI: doi:10.1177/1759720X221081652


Introduction: Post hoc analyses of osteoporosis trials have suggested that alendronate and strontium ranelate may be associated with a reduction in the progression of spinal radiographic osteoarthritis (OA). We performed an analysis on a subgroup of participants in the horizon PFT trial (a 3-year randomized controlled trial (RCT) of yearly zoledronic acid (ZA) in postmenopausal women with osteoporosis), to evaluate the effect of ZA on the structural progression of spinal osteophytes (OPh) and disk space narrowing (DN).

Methods: Paired lateral spinal X-rays (baseline and 36 months) were selected from the horizon PFT trial records restricted to those with radiographic OA at baseline. The X-rays were analyzed by two readers blinded to the treatment allocation. OPh and DN were scored separately using the Lane atlas (0-3 for increasing severity at each vertebral level) at all evaluable levels from T4-12 and L1-5.

Results: A total of 504 sets of paired radiographs were included in the analysis, 245 in the ZA group and 259 in the placebo group. Overall, the rates of change of OPh and DN scores were low, and they were not statistically different between the groups (change in the whole spine OPh ZA 1.0 1.6, placebo 0.8 1.3, p = 0.1; DN ZA 0.3 1.0, placebo 0.3 0.8, p = 0.7).

Conclusion: Yearly ZA for 3 years was not associated with a slowing of progression of OPh or DN in the thoracolumbar spine in patients with pre-existing radiographic OA.

Item Details

Item Type:Refereed Article
Keywords:bisphosphonates, spinal osteoarthritis, treatment, zoledronic acid
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Rheumatology and arthritis
Objective Division:Health
Objective Group:Clinical health
Objective Field:Treatment of human diseases and conditions
UTAS Author:Laslett, LL (Dr Laura Laslett)
UTAS Author:Jones, G (Professor Graeme Jones)
ID Code:154035
Year Published:2022
Deposited By:Menzies Institute for Medical Research
Deposited On:2022-10-25
Last Modified:2022-11-21
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