Effect of Intravenous Zoledronic Acid on Total Knee Replacement in Patients With Symptomatic Knee Osteoarthritis and Without Severe Joint Space Narrowing: A Prespecified Secondary Analysis of a Two‐Year, Multicenter, Double‐Blind, Placebo‐Controlled Clinical Trial
Authors' conclusion
These results suggest that ZA is not protective against TKR in patients with symptomatic knee osteoarthritis and without severe JSN.
Study context
- Population
- Patients with symptomatic knee OA and without severe joint space narrowing (mean age 62 years, 52% female)
- Participants
- 222 patients
- Comparison
- Zoledronic acid (ZA) 5 mg annually vs placebo
- ZAn = 113
- Placebon = 109reference
- Primary endpoint
- Risk of primary total knee replacement (any knee and study knee)
Methodological detailsprespecified secondary analysis, multicentre, double-blind, placebo-controlled, two-year trial, Cox proportional hazard regression, time-varying coefficients analysis, Trial conducted November 2013 to October 2017; primary total knee replacement (TKR) identified until February 22, 2022
- Prespecified secondary analysis
- Multicentre
- Double-blind
- Placebo-controlled
- Two-year trial
- Cox proportional hazard regression
- Time-varying coefficients analysis
- Trial conducted November 2013 to October 2017; primary TKR identified until February 22, 2022
Primary result
As reported in the abstract
TKR during the trial (within 2 years of randomisation) · within two years of randomization
ZA vs PlaceboHazard ratio (95% CI)
Any knee
4.2(1.2–14.7)
Study knee; trend
6.8(0.9–53.9)
Further findings
Proportion with TKR over follow-up · mean follow-up of seven years · value = any TKR
TKR in study knee
| Outcome | HR (95% CI) | |
|---|---|---|
| TKR in the posttrial period · after two years of randomizationAny knee | 1.2 (0.5–1.8) | |
| TKR in the posttrial period · after two years of randomizationStudy knee | 1.4 (0.5–2.2) | |
| 0.512Hazard ratio (log scale) |
TKR in the posttrial period · after two years of randomization
- Risk of TKR similar in the ZA and placebo groups
Original publication
Effect of Intravenous Zoledronic Acid on Total Knee Replacement in Patients With Symptomatic Knee Osteoarthritis and Without Severe Joint Space Narrowing: A Prespecified Secondary Analysis of a Two‐Year, Multicenter, Double‐Blind, Placebo‐Controlled Clinical Trial. Arthritis Rheumatol. Published 13 March 2024. doi:10.
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