The Effect of Prophylactic Use of NSAIDs on Acute Phase Reactions Induced by First-Time Zoledronic Acid Treatment for Osteoporosis.

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Annals of Pharmacotherapy Pub Date : 2026-11-01 Epub Date: 2025-10-16 DOI:10.1177/10600280251367582

Qiuling Wang, Weiyang Zhang, Wencan Lu, Weipeng Ai

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引用次数: 0

Abstract

Background: Zoledronic acid is a first-line treatment for primary osteoporosis, but its high acute-phase-reaction (APR) incidence can reduce patient compliance and long-term efficacy. Non-steroidal anti-inflammatory drugs (NSAIDs), with antipyretic and analgesic effects, can relieve APR symptoms like fever and muscle soreness caused by zoledronic acid. However, the role of prophylactic NSAID use in decreasing APRs remains controversial.

Objective: This study aims to evaluate the impact of NSAIDs on preventing zoledronic acid-related APRs to guide clinical practice.

Methods: Retrospective data of osteoporosis patients receiving zoledronic acid injection at Shenzhen University General Hospital from January 2023 to December 2024 were collected. A 1:2 propensity score matching (PSM) compared the APR incidences between the non-NSAIDs and NSAIDs groups.

Results: Among 351 cases (98 non-NSAIDs, 253 NSAIDs), 200 cases (79 non-NSAIDs, 121 NSAIDs) remained after PSM. The NSAIDs group had a lower overall APR incidence (38.0% vs. 53.2%, χ² = 4.451, P = .035). There was no significant difference in fever incidence (χ2 = 1.888, P = .169), but pain incidence was lower in the NSAIDs group (25.3% vs. 9.9%, χ² = 8.433, P = .004). Flurbiprofen axetil, ibuprofen, and etoricoxib showed similar APR-preventive effects.

Conclusion and relevance: Prophylactic NSAIDs significantly reduce zoledronic acid-induced APRs, especially pain, but have no significant effect on preventing fever. The 3 NSAIDs also have comparable efficacy.

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预防性使用非甾体抗炎药对首次唑来膦酸治疗骨质疏松症急性期反应的影响。

背景：唑来膦酸是治疗原发性骨质疏松症的一线药物，但其较高的急性期反应（APR）发生率降低了患者的依从性和远期疗效。非甾体抗炎药（NSAIDs）具有解热镇痛作用，可缓解唑来膦酸引起的发热、肌肉酸痛等APR症状。然而，预防性使用非甾体抗炎药在降低APRs中的作用仍然存在争议。目的：评价非甾体抗炎药对唑来膦酸相关APRs的预防作用，以指导临床实践。方法：回顾性收集2023年1月至2024年12月在深圳大学总医院接受唑来膦酸注射液治疗的骨质疏松症患者的资料。采用1:2倾向评分匹配（PSM）比较非NSAIDs组和NSAIDs组APR发生率。结果：351例患者（非甾体抗炎药98例，非甾体抗炎药253例）中，经PSM治疗后仍有200例（非甾体抗炎药79例，非甾体抗炎药121例）。非甾体抗炎药组APR总发生率较低（38.0%比53.2%,χ2 = 4.451, P = 0.035）。两组患者发热发生率差异无统计学意义（χ2 = 1.888, P = 0.169），疼痛发生率差异有统计学意义（25.3%比9.9%,χ2 = 8.433, P = 0.004）。氟比洛芬酯、布洛芬和依托昔布具有相似的apr预防效果。结论及意义：预防性非甾体抗炎药可显著降低唑来膦酸引起的apr，尤其是疼痛，但对预防发热无显著作用。3种非甾体抗炎药的疗效也相当。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Pharmacotherapy 医学-药学

CiteScore

5.70

自引率

0.00%

发文量

166

审稿时长

3-8 weeks

期刊介绍： Annals of Pharmacotherapy (AOP) is a peer-reviewed journal that advances pharmacotherapy throughout the world by publishing high-quality research and review articles to achieve the most desired health outcomes.The articles provide cutting-edge information about the most efficient, safe and cost-effective pharmacotherapy for the treatment and prevention of various illnesses. This journal is a member of the Committee on Publication Ethics (COPE). Average time from submission to first decision: 14 days