Zoledronic Acid for Nonmalignant Painful Bone Marrow Lesions .
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Efficacy of Zoledronic Acid in the Treatment of Nonmalignant Painful Bone Marrow Lesions: A Triple-Blind, Randomized, Placebo-Controlled Phase III Clinical Trial (ZoMARS)
J Bone Miner Res. 2022 Mar;37(3): 420-427.48 patients with painful bone marrow lesions were randomized to receive Vitamin D and calcium supplementation plus a single dose of intravenous Zoledronic acid (n=34) or placebo (n=14). The primary outcome of interest was the change in volume/size of the lesion. Secondary outcomes of interest included pain on a Visual Analog Scale (VAS), pain disability index (PDI), bone-specific quality of life questionnaire (Qualeffo-41), and adverse events. Results revealed a significantly greater reduction in lesion volume with zoledronic acid, demonstrating a mean reduction of 64.53% vs. an increase in lesion size of 14.43% in the placebo group. VAS pain scores were significantly in favour of the Zoledronic acid group between 6 and 12 weeks follow up. 31 patients reported 83 adverse drug reactions in the Zoledronic acid group, vs. 6 patients and 13 adverse drug reactions in the placebo group.
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