Meenal Jain et al 6 jsafoms A Comparative Study of Use of Zoledronic Acid and Teriparatide in Postmenopausal Osteoporosis 1 Meenal Jain, 2 Amit Agarwal, 3 Ruchika Garg ABSTRACT Aim: To study and compare the effect of zoledronic acid and teriparatide on bone mineral density in postmenopausal women with osteoporosis. Materials and methods: One hundred postmenopausal patients having BMD score < 1 were selected from the out- patient department of gynecology, SN Medical College, Agra. The study was undertaken in collaboration with orthopedician, randomly divided into two groups: group A—Fifty patient given 5 mg Iv zoledronic acid infusion, two such doses were given at 6 months interval, group B—Fifty patient given 20 µg/day teriparatide by subcutaneous injection for 3 months. Follow-up at 12 months and BMD score compared. Observations: There was signiicant increase in BMD in both the groups over a period of 1 year but increase was more signi- icant in teriparatide group (8 to 10%) as compared to 4 to 6% increase in zoledronic acid group. Clinical symptoms improved in both groups with fewer side effects in teriparatide group. Conclusion: Both teriparatide and zoledronic acid are good options for management of postmenopausal osteoporosis with teriparatide having better clinical ef icacy and less side effects though it is expensive and requires daily administration. Keywords: Bone mineral density, Postmenopausal osteo- porosis, Teriparatide, Zoledronic acid. How to cite this article: Jain M, Agarwal A, Garg R. A Com- parative Study of Use of Zoledronic Acid and Teriparatide in Postmenopausal Osteoporosis. J South Asian Feder Meno- pause Soc 2015;3(1):6-8. Source of support: Nil Conlict of interest: None Date of submission: 8 Feb 2015 Date of acceptance: 1 May 2015 Date of publication: June 2015 INTRODUCTION Osteoporosis is most prevalent in women over the age of 50 as the hormonal inluence of estrogen on bone health original article 1,3 Assistant Professor, 2 Associate Professor 1,3 Department of Obstetrics and Gynecology, SN Medical College, Agra, Uttar Pradesh, India 2 Department of Orthopedics, FH Medical College, Agra Uttar Pradesh, India Corresponding Author: Meenal Jain, Assistant Professor, Depart- ment of Obstetrics and Gynecology, SN Medical College, Agra Uttar Pradesh, India, Phone: 9837453303, e-mail: drmeenalgyne@ gmail.com 10.5005/jp-journals-10032-1061 dissipates with the onset of menopause. The progressive changes in bone structure, quality and density lead to pathological fractures and an increase in morbidity and mortality among menopausal women while a perfect treatment has yet to be discovered to completely cure this progressive disease many breakthroughs have been made in order to prevent fractures and improve quality of life. Though the use of hormone replacement therapy (HRT) is an effective preventive measure but the risk of breast cancer and coronary events has lead to the use of non- hormonal agents for prevention of osteoporotic fractures. The different pharmacologic groups available are: bisphosphonates—considered as irst line therapy. These are etidronate, alendronate, risedronate and zoledronic acid, parathyroid hormone 1 to 34 (teriparatide), calcitonin— tibolone and new experimental therapies—strontium ranelate, parathyroid 1 to 84, bazedoxifene, lasofoxifene, denosumab. This study was undertaken to study and compare the effectiveness of zoledronic acid and teri- paratide on bone mineral density in postmenopausal women with osteoporosis. MATERIALS AND METHODS One hundred postmenopausal patients having BMD score < 1 were recruited for the study and randomly divided into two groups as follows: • Group A (50 patients)—zoledronic acid given in a dose of 5 mg IV infusion at each sitting over a period of 30 minutes. Two such doses at 6 months interval were given. • Group B (50 patients)—teriparatide given in a dose of 20 µg/day by subcutaneous injection for 3 months. Bone mineral density measurement of calcaneum was done. we followed the patients at 6 and 12 months and evaluated their BMD and clinical proile. Exclusion Criteria Have an increased risk of osteosarcoma (bone tumor), this includes Paget’s diseases of bone, a previous bone tumor or radiation involving the skeleton. • Are allergic to teriparatide or zoledronic acid. • Have a vitamin D level below 10 ng/ml. • Have active live disease. • Have signiicantly impaired kidney function.