{"id":22340,"date":"2025-09-04T16:29:18","date_gmt":"2025-09-04T20:29:18","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=22340"},"modified":"2025-09-08T16:33:36","modified_gmt":"2025-09-08T20:33:36","slug":"the-relationship-between-osteoporosis-treatment-history-and-receipt-of-a-second-zoledronic-acid-dose","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/the-relationship-between-osteoporosis-treatment-history-and-receipt-of-a-second-zoledronic-acid-dose\/","title":{"rendered":"The relationship between osteoporosis treatment history and receipt of a second zoledronic acid dose"},"content":{"rendered":"<p><strong>Summary<\/strong> \u2014 We examined characteristics of patients in Ontario, Canada, initiating publicly funded zoledronic acid for osteoporosis from 2006 to 2021. Most patients had prior osteoporosis treatments, with those previously using oral bisphosphonates more likely to receive a second dose. Understanding treatment decisions and patient beliefs is key for future research.<\/p>\n<p><strong>Purpose<\/strong> \u2014 Zoledronic acid is a once-yearly intravenous bisphosphonate and is considered a second-line osteoporosis therapy in Ontario, Canada. This regimen was approved using evidence from clinical trials of treatment-na\u00efve patients. However, many patients initiating zoledronic acid have used other osteoporosis medications prior, which may influence the frequency of dosing. We describe the characteristics of patients initiating zoledronic acid and identify if previous osteoporosis pharmacotherapy impacts the receipt of a second dose.<\/p>\n<p><strong>Methods<\/strong> \u2014 Healthcare administrative data in Ontario were used to identify older patients initiating publicly funded zoledronic acid from 10\/2006 to 10\/2021 and followed until 10\/2022. Patients were categorized based on 5-year osteoporosis treatment look back history in mutually exclusive groups: (1) no history, (2) denosumab, (3) oral bisphosphonates, and (4) other osteoporosis medications. Cox proportional hazards models were used to compare receipt of a second zoledronic acid infusion between patients in treatment history groups.<\/p>\n<p><strong>Results<\/strong> \u2014 We identified 3308 patients initiating zoledronic acid; median age\u2009=\u200977, 81% female, 31% received a second infusion of zoledronic acid. Half (49%) had a history of oral bisphosphonates, 37% no history, 11% denosumab, and 3% other medications. Overall, patients having history of oral bisphosphonates were 1.5 times more likely to receive a second dose relative to no history (HR, 95%CI: 1.50 [1.31\u20131.71]).<\/p>\n<p><strong>Conclusion<\/strong> \u2014 In contrast to patients in pivotal trials, most patients receiving zoledronic acid had prior osteoporosis pharmacotherapy. Patients with prior oral bisphosphonate use had higher rates of receiving a second dose. Better understanding of treatment decisions and patient beliefs around receiving a second infusion of zoledronic acid should be further investigated.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Summary \u2014 We examined characteristics of patients in Ontario, Canada, initiating publicly funded zoledronic acid for osteoporosis from 2006 to 2021. Most patients had prior osteoporosis treatments, with those previously using oral bisphosphonates more likely to receive a second dose. Understanding treatment decisions and patient beliefs is key for future research. Purpose \u2014 Zoledronic acid [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[51,56],"migration-helper-qa-sample-set":[],"class_list":["post-22340","journal_article","type-journal_article","status-publish","hentry","topic-musculoskeletal-diseases-and-disorders","topic-pharmacoepidemiology-and-drug-safety"],"acf":{"citation":"Konstantelos N, Kim S, Cheung AM, Burden AM, Grootendorst P, Cadarette SM. <em>Osteoporos Int<\/em>. 2025 Sep 4 [Epub ahead of print].","source_url":"https:\/\/doi.org\/10.1007\/s00198-025-07672-1","ices_scientist":[1204],"site":[6735],"research_program":[6746],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | The relationship between osteoporosis treatment history and receipt of a second zoledronic acid dose<\/title>\n<meta name=\"description\" content=\"Summary \u2014 We examined characteristics of patients in Ontario, Canada, initiating publicly funded zoledronic acid for osteoporosis from 2006 to 2021. 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