F. Bellone, A. Catalano, Sottile Ar
May 28, 2021
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Abstract
Zoledronic acid (Zol) is a widely used intravenous aminobisphosphonate to treat both benign and malignant skeletal diseases, and bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a serious side effect whose pathophysiology remains poorly understood. Vascular Endothelial Growth Factor (VEGF) has been recognized to mediate BRONJ in cancer patients undergoing Zol treatment, however data on VEGF are lacking in patients with osteoporosis. The aim of this study was to investigate the influence of Zol on VEGF levels in women with postmenopausal osteoporosis.28 postmenopausal women with osteoporosis were enrolled and randomized into 2 groups to receive Zol (5 mg) or placebo. At baseline, at day-3 and day-30 VEGF serum levels were measured; bone turnover markers, 25-hydroxyvitamin D (25(OH)D) and serum calcium were evaluated at baseline.In Zol-treated women, VEGF increased significantly on day-3, and then decreased on day-30. The VEGF change (-18% at day-30 vs. baseline, p=0.01) was significantly associated with 25(OH)D levels, after correcting for age, BMI, time since menopause, femoral neck BMD, osteocalcin, C-terminal telopeptide of type 1 collagen and baseline VEGF levels.For the first time, we detected early modifications of circulating VEGF in postmenopausal women receiving Zol for osteoporosis, identifying a vitamin D-dependent modulation of these changes.