{"title":"缓解唑来膦酸治疗后急性期反应的新型联合药物疗法","authors":"Chung-Hwan Chen, En Kee Yeap, Chia-Hao Hsu, Yen-Mou Lu, Tsung-Lin Cheng, Tien-Ching Lee, Cheng-Jung Ho, Jhong-You Li, Hsin-Yi Shen, Hsuan-Ti Huang, Cheng-Chang Lu, Sung-Yen Lin","doi":"10.1007/s11657-024-01452-w","DOIUrl":null,"url":null,"abstract":"<div><h3>\n <i>Summary</i>\n </h3><p><b>Brief rationale:</b> Zoledronic acid treatment against osteoporosis is limited by APR. <b>Main result:</b> Combination therapy (hydrocortisone plus non-steroidal anti-inflammatory drugs, acetaminophen, and prednisolone) reduced intolerable APR levels and provided complete symptom relief in most patients. <b>Significance of the paper:</b> Combination therapy can enhance patient outcomes in osteoporosis management.</p><h3>Purpose</h3><p>Osteoporosis is a common condition associated with high morbidity rates, often requiring treatment with bisphosphonates such as zoledronic acid. However, the persistence to zoledronic acid infusion is commonly limited by acute phase response (APR). This retrospective study aimed to evaluate the efficacy of a novel combination therapy in preventing APR symptoms.</p><h3>Methods</h3><p>A retrospective case–control study was conducted on 931 patients who received their first zoledronic acid infusion between 2011 and 2021. We evaluated the efficacy of combination therapy comprising a single dose of hydrocortisone prior to the infusion and a 3-d oral regimen of non-steroidal anti-inflammatory drugs, acetaminophen, and prednisolone following the infusion. Patients were divided into protocol (receiving combination therapy) and control groups (without treatment). Baseline characteristics, APR incidence, and the efficacy of symptom control were compared between groups using Fisher’s exact test and Student’s <i>t</i>-test.</p><h3>Results</h3><p>There was no difference in APR incidence between the protocol (<i>n</i> = 507) and control group (<i>n</i> = 407; <i>p</i> = 0.1442). However, the protocol group exhibited lower intolerable APR levels (3.72% vs. 16.71%; <i>p</i> < 0.0001) and complete symptom relief in 96.28% of cases.</p><h3>Conclusion</h3><p>The combination therapy protocol effectively reduced intolerable APR and relieved symptoms in most patients following zoledronic acid infusion. This study highlights the importance of proactive management strategies for APR and emphasizes the potential of combination therapy in alleviating APR symptoms and reducing the occurrence of severe APR in patients undergoing osteoporosis management.</p></div>","PeriodicalId":3,"journal":{"name":"ACS Applied Electronic Materials","volume":null,"pages":null},"PeriodicalIF":4.3000,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s11657-024-01452-w.pdf","citationCount":"0","resultStr":"{\"title\":\"Novel combined pharmacological strategy to alleviate acute phase response following zoledronic acid treatment\",\"authors\":\"Chung-Hwan Chen, En Kee Yeap, Chia-Hao Hsu, Yen-Mou Lu, Tsung-Lin Cheng, Tien-Ching Lee, Cheng-Jung Ho, Jhong-You Li, Hsin-Yi Shen, Hsuan-Ti Huang, Cheng-Chang Lu, Sung-Yen Lin\",\"doi\":\"10.1007/s11657-024-01452-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>\\n <i>Summary</i>\\n </h3><p><b>Brief rationale:</b> Zoledronic acid treatment against osteoporosis is limited by APR. <b>Main result:</b> Combination therapy (hydrocortisone plus non-steroidal anti-inflammatory drugs, acetaminophen, and prednisolone) reduced intolerable APR levels and provided complete symptom relief in most patients. <b>Significance of the paper:</b> Combination therapy can enhance patient outcomes in osteoporosis management.</p><h3>Purpose</h3><p>Osteoporosis is a common condition associated with high morbidity rates, often requiring treatment with bisphosphonates such as zoledronic acid. However, the persistence to zoledronic acid infusion is commonly limited by acute phase response (APR). This retrospective study aimed to evaluate the efficacy of a novel combination therapy in preventing APR symptoms.</p><h3>Methods</h3><p>A retrospective case–control study was conducted on 931 patients who received their first zoledronic acid infusion between 2011 and 2021. We evaluated the efficacy of combination therapy comprising a single dose of hydrocortisone prior to the infusion and a 3-d oral regimen of non-steroidal anti-inflammatory drugs, acetaminophen, and prednisolone following the infusion. Patients were divided into protocol (receiving combination therapy) and control groups (without treatment). Baseline characteristics, APR incidence, and the efficacy of symptom control were compared between groups using Fisher’s exact test and Student’s <i>t</i>-test.</p><h3>Results</h3><p>There was no difference in APR incidence between the protocol (<i>n</i> = 507) and control group (<i>n</i> = 407; <i>p</i> = 0.1442). However, the protocol group exhibited lower intolerable APR levels (3.72% vs. 16.71%; <i>p</i> < 0.0001) and complete symptom relief in 96.28% of cases.</p><h3>Conclusion</h3><p>The combination therapy protocol effectively reduced intolerable APR and relieved symptoms in most patients following zoledronic acid infusion. This study highlights the importance of proactive management strategies for APR and emphasizes the potential of combination therapy in alleviating APR symptoms and reducing the occurrence of severe APR in patients undergoing osteoporosis management.</p></div>\",\"PeriodicalId\":3,\"journal\":{\"name\":\"ACS Applied Electronic Materials\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2024-10-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://link.springer.com/content/pdf/10.1007/s11657-024-01452-w.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ACS Applied Electronic Materials\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://link.springer.com/article/10.1007/s11657-024-01452-w\",\"RegionNum\":3,\"RegionCategory\":\"材料科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENGINEERING, ELECTRICAL & ELECTRONIC\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACS Applied Electronic Materials","FirstCategoryId":"3","ListUrlMain":"https://link.springer.com/article/10.1007/s11657-024-01452-w","RegionNum":3,"RegionCategory":"材料科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENGINEERING, ELECTRICAL & ELECTRONIC","Score":null,"Total":0}
Novel combined pharmacological strategy to alleviate acute phase response following zoledronic acid treatment
Summary
Brief rationale: Zoledronic acid treatment against osteoporosis is limited by APR. Main result: Combination therapy (hydrocortisone plus non-steroidal anti-inflammatory drugs, acetaminophen, and prednisolone) reduced intolerable APR levels and provided complete symptom relief in most patients. Significance of the paper: Combination therapy can enhance patient outcomes in osteoporosis management.
Purpose
Osteoporosis is a common condition associated with high morbidity rates, often requiring treatment with bisphosphonates such as zoledronic acid. However, the persistence to zoledronic acid infusion is commonly limited by acute phase response (APR). This retrospective study aimed to evaluate the efficacy of a novel combination therapy in preventing APR symptoms.
Methods
A retrospective case–control study was conducted on 931 patients who received their first zoledronic acid infusion between 2011 and 2021. We evaluated the efficacy of combination therapy comprising a single dose of hydrocortisone prior to the infusion and a 3-d oral regimen of non-steroidal anti-inflammatory drugs, acetaminophen, and prednisolone following the infusion. Patients were divided into protocol (receiving combination therapy) and control groups (without treatment). Baseline characteristics, APR incidence, and the efficacy of symptom control were compared between groups using Fisher’s exact test and Student’s t-test.
Results
There was no difference in APR incidence between the protocol (n = 507) and control group (n = 407; p = 0.1442). However, the protocol group exhibited lower intolerable APR levels (3.72% vs. 16.71%; p < 0.0001) and complete symptom relief in 96.28% of cases.
Conclusion
The combination therapy protocol effectively reduced intolerable APR and relieved symptoms in most patients following zoledronic acid infusion. This study highlights the importance of proactive management strategies for APR and emphasizes the potential of combination therapy in alleviating APR symptoms and reducing the occurrence of severe APR in patients undergoing osteoporosis management.
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