[Risk factors of acute-phase response following the first-dose administration of zoledronic acid in the treatment of osteoporosis].

Objective To explore the risk factors of acute-phase response(APR) following the first-dose administration of zoledronic acid in the treatment of osteoporosis.Methods We reviewed the clinical data of the patients receiving the first use of zoledronic acid 5 mg treatment of osteoporosis from January 2009 to November 2012,and divided the patients into acute phase response group(APR+) and no response group(APR-).The age,body mass index(BMI),concomitant medications,comorbidities,laboratory parameters between the two groups were compared and analyzed.Results A total of 178 patients were eligible for inclusion in the study,of which 108 patients experienced APR.In APR group,there were 80(44.9%) patients developed fever,14(9.6%) chills,48(27.0%) musculoskeletal pain,19(10.7%) gastrointestinal symptoms,10(5.6%) headache and dizziness,7(3.9%) palpitation,and 3(1.7%) rash.APR was more common in the patients with higher baseline tartrate-resistant acid phosphatase 5b(TRACP-5b) and new-onset vertebral compression fractures(new-onset VCF).Stepwise logistic regression showed that the odds ratio(OR) of APR in higher baseline TRACP-5b and new VCF was 3.3 and 2.5 respectively.Conclusion The first use of zoledronic acid in the treatment of osteoporosis appears high incidence of APR.High TRACP-5b levels and new vertebral fracture are risk factors for APR.