Surgical trauma and low‑dose methylprednisolone modulate the severity of the acute‑phase response induced by zoledronic acid infusion

  • Authors:
    • Jian Chen
    • Lipeng Yu
    • Lixin Chen
    • Xuan Wu
    • Pengyu Tang
    • Jian Yin
    • Tao Jiang
    • Guoyong Yin
    • Jin Fan
  • View Affiliations

  • Published online on: June 22, 2017     https://doi.org/10.3892/etm.2017.4646
  • Pages: 1802-1808
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Abstract

The aim of the present study was to investigate risk factors for the development of an acute‑phase response (APR) associated with the initial zoledronic acid (ZA) infusion in patients undergoing surgery, and to assess whether its onset may be reduced by post‑dose administration of low‑dose methylprednisolone (MP) or acetaminophen. A retrospective study of patients with osteoporosis who attended the departments of orthopedics and endocrinology of a single hospital and received 5 mg ZA was conducted; the patients included surgical and non‑surgical cases. A total of 450 ZA‑naïve patients who were treated with acetaminophen following ZA infusion were stratified based on whether they suffered APR (APR+) or not (APR‑). In addition, 155 of the aforementioned acetaminophen‑treated patients (acetaminophen group) were compared with another 32 patients from the orthopedic department who were treated with MP immediately following ZA infusion (MP group). Inflammatory marker levels were significantly higher in APR+ patients than in APR‑ patients, and the odds ratios of experiencing APR following minimally invasive or open surgery were found to be 3.54 (P<0.001) and 5.71 (P<0.001), respectively, compared with non‑surgical intervention after multiple adjustments. C‑reactive protein levels prior to dosing were positively correlated with body temperature (r=0.023; P<0.001). The severity of APR also exhibited a negative correlation with 23‑hydroxyvitamin D3 levels (r=‑0.006; P<0.05). Patients treated with MP following surgery and ZA infusion had a significantly lower incidence of APR compared with those treated with acetaminophen (6.3 vs. 62.6%; P<0.05). However, no significant differences were observed in bone mineral density between the MP and acetaminophen groups at 12 months post‑surgery. The results of the present study suggest that surgical trauma serves a key role in ZA‑associated APR, and low‑dose MP may a suitable post‑dose treatment to manage the symptoms of APR in patients undergoing surgery.
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August-2017
Volume 14 Issue 2

Print ISSN: 1792-0981
Online ISSN:1792-1015

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Spandidos Publications style
Chen J, Yu L, Chen L, Wu X, Tang P, Yin J, Jiang T, Yin G and Fan J: Surgical trauma and low‑dose methylprednisolone modulate the severity of the acute‑phase response induced by zoledronic acid infusion. Exp Ther Med 14: 1802-1808, 2017
APA
Chen, J., Yu, L., Chen, L., Wu, X., Tang, P., Yin, J. ... Fan, J. (2017). Surgical trauma and low‑dose methylprednisolone modulate the severity of the acute‑phase response induced by zoledronic acid infusion. Experimental and Therapeutic Medicine, 14, 1802-1808. https://doi.org/10.3892/etm.2017.4646
MLA
Chen, J., Yu, L., Chen, L., Wu, X., Tang, P., Yin, J., Jiang, T., Yin, G., Fan, J."Surgical trauma and low‑dose methylprednisolone modulate the severity of the acute‑phase response induced by zoledronic acid infusion". Experimental and Therapeutic Medicine 14.2 (2017): 1802-1808.
Chicago
Chen, J., Yu, L., Chen, L., Wu, X., Tang, P., Yin, J., Jiang, T., Yin, G., Fan, J."Surgical trauma and low‑dose methylprednisolone modulate the severity of the acute‑phase response induced by zoledronic acid infusion". Experimental and Therapeutic Medicine 14, no. 2 (2017): 1802-1808. https://doi.org/10.3892/etm.2017.4646