Rabia BAĞ SOYTAŞ, Suna AVCI, Hakan YAVUZER, Serdar ÖZKÖK, Alper DÖVENTAŞ, Deniz Suna ERDİNÇLER

65 Yaş Üstü Osteoporoz Hastalarında Denosumab ve Zoledronik Asit’in Yan Etkilerinin Karşılaştırılması

Amaç: Osteoporoz tedavisi alan hastalarda, zoledronik asit ve denosumab kullanım oranları ile bu iki ilacın yan etkilerini karşılaştırmayı amaçladık. Gereç ve Yöntem: Çalışmamızda Ocak 2016-Aralık 2017 tarihleri arasında başvuran hastaların dosyaları taranarak, osteoporoz tanısıyla zoledronik asit ve denosumab almış olanlar belirlendi. Klinik ve demografik verileri, tedavi başlangıcı, 6. ay ve 1. yıl laboratuvar değerleri ile ilaç yan etkileri kaydedildi. Bulgular: Çalışmaya 171 hasta dâhil edildi. Denosumab alanlar daha yaşlı, üre ve kreatinin değerleri daha yüksek, kreatinin klirensleriyse daha düşüktü. Yan etki açısından değerlendirildiğinde hipokalsemi, denosumab verilenlerin 1’inde (%1,29) görülürken; zoledronik asit verilenlerde rastlanmadı. Denosumab alanların 4’ünde (% 5,19), zoledronik asit alanların ise 2’sinde (% 2,12) 1 aylık takipte akut böbrek yetmezliği gelişti. Zoledronik asit alanların 2’sinde (% 2,12) grip benzeri semptomlar görülürken; denosumab alanlarda gözlenmedi. Ayrıca zoledronik asit alanların 1’inde (% 1,06) tedavi sonrası çene osteonekrozu olmaksızın, 6 dişinde kendiliğinden dökülme; denosumab alanların 1’inde (% 1,29) ise iskium pubiste bilateral spontan kırık tespit edildi. Sonuç: İki ajan karşılaştırıldığında, yan etki açısından iki grup arasında anlamlı fark olmadığı; gelişen yan etkilerin ise literatürde belirtilenden daha az olduğu; kullanılacak ajanın seçiminde komorbidite yanı sıra, çoklu ilaç kullanımı ve nadir yan etkilerin akılda tutulması gerektiği kanısına varıldı.

Anahtar Kelimeler:

Geriatri, Zoledronik asit, Denosumab, Yan Etki

Comparison Side Effects of Denosumab and Zoledronic Acid in Osteoporosis Patients Over 65 Years Old

Objective: We aimed to compare the rates of denosumab and zoledronic acid in patients receiving osteoporosis treatment and the side effects of these drugs. Material and Method: In our study, the files of the applicants were searched between January 2016-December 2017; those with denosumab and zoledronic acid. Clinical and demographic data, laboratory values of beginning of treatment, 6 months and 1 year and side effects were recorded. Results: 171 patients were included. Denosumab group was older, their urea and creatinine levels were higher and GFRs were lower. Hypocalcemia was observed only in denosumab group (1 (1.23%) patient). Acut renal failure occured in 4 (% 5,19) patients with denosumab and 2 (%2,12) patients with the other group during 1 month follow up. Flu-like symptomps were observed only in zoledronic asit group (2 (%2,12) patients). Bilateral spontaneous fracture of the ischium pubis was observed in 1 (1.29%) of the former, spontaneous 6 teeth loss in 1 (1.06%) of the latter group. Conclusion: There were no significant differences between two groups in terms of side effects. Side effects were lower than those reported in the literature; in addition to comorbidity, multiple drug use and rare side effects should be kept in mind.

Keywords:

Geriatric, Zoledronic acid, Denosumab, Side effect,

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