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Effect of zoledronic acid with or without methylprednisolone on 3D bone area and bone shape in patients with symptomatic knee osteoarthritis: A post-hoc analysis of the ZAP2 trial

Citation

Cai, G and Laslett, LL and Bowes, MA and Conaghan, PG and Cicuttini, F and Wluka, E and March, L and Hill, C and Winzenberg, T and Jones, G and Aitken, D, Effect of zoledronic acid with or without methylprednisolone on 3D bone area and bone shape in patients with symptomatic knee osteoarthritis: A post-hoc analysis of the ZAP2 trial, Seminars in Arthritis and Rheumatism, 56 Article 152054. ISSN 0049-0172 (2022) [Refereed Article]

Copyright Statement

Copyright (2022) Elsevier Inc. All rights reserved.

DOI: doi:10.1016/j.semarthrit.2022.152054

Abstract

Objective: To evaluate the effect of annual infusions of zoledronic acid (ZA) with or without a single injection of methylprednisolone, compared to placebo, on quantitative magnetic resonance imaging 3-D bone area and bone shape in participants with symptomatic knee osteoarthritis (OA).

Methods: This was a post-hoc analysis of the ZAP2 trial. Active appearance modelling was used to assess bone area (mm2) and femur bone shape (B-score) in 262 participants (mean 61.8 8.0 years, 51% female) at baseline, 6, and 24 months. Radiographic joint space narrowing (JSN) was measured at baseline. An 'OA shape' was defined as a B-score of >1.96.

Results: At baseline 65% of participants demonstrated an OA shape. Treatment with ZA plus methylprednisolone but not ZA alone, compared to placebo, was associated with significantly slower expansion in bone area at the medial femoral (-33.9 mm2, 95% confidence interval [CI] -61.8 to -6.0) and lateral femoral (-22.0 mm2, 95%CI -40.7 to -3.4) compartments over 24 months. B-score increased in all groups, with no significant between-group differences. There were significant interactions of JSN (grade 0 vs grade 1-2) and B-score (≤1.96 vs >1.96) with treatment effect on bone area (p < 0.05), such that ZA plus methylprednisolone slowed the expansion of medial and lateral femoral bone area over 24 months in participants with JSN grade 1-2 or a B-score of >1.96.

Conclusions: ZA plus methylprednisolone may retard expansion of bone area over 24 months, but ZA alone may not. Neither ZA with or without methylprednisolone slowed progression of bone shape over 6 or 24 months.

Item Details

Item Type:Refereed Article
Keywords:bone area, bone shape, methylprednisolone, osteoarthritis, 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:Cai, G (Dr Guoqi Cai)
UTAS Author:Laslett, LL (Dr Laura Laslett)
UTAS Author:Winzenberg, T (Professor Tania Winzenberg)
UTAS Author:Jones, G (Professor Graeme Jones)
UTAS Author:Aitken, D (Associate Professor Dawn Aitken)
ID Code:154046
Year Published:2022
Deposited By:Menzies Institute for Medical Research
Deposited On:2022-10-26
Last Modified:2022-11-18
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