Objective: To investigate the effectiveness and safety of combining zoledronic acid with calcium supplements and calcitriol in treating primary osteoporosis in elderly patients.

Methods: Seventy-eight elderly patients with primary osteoporosis were recruited. They were randomly assigned in a 1:1 ratio to either the CC group (calcium carbonate D3 tablets + calcitriol soft capsules) or the CCZ group (calcium carbonate D3 tablets + calcitriol soft capsules + zoledronic acid injection). The treatment duration was 1 year. Bone mineral density (BMD), bone metabolism markers, quality of life (QoL), clinical efficacy, and incidence of adverse reactions (ARs) were assessed.

Results: CCZ group showed increased BMD in the lumbar spine (L1~L4 segments), femoral neck, and hip after treatment relative to CC group. Serum levels of bone-specific alkaline phosphatase, cross-linked type 1 collagen C-terminal peptide, and N-terminal propeptide of type 1 procollagen decreased, while osteocalcin levels increased. The QoL Questionnaire of the European Foundation for Osteoporosis scores decreased (P < 0.05 for all comparisons). The clinical effective rates were 76.93% in the CC group and 92.31% in the CCZ group, with AR rates of 23.08% and 12.82%, respectively (P < 0.05 for both).

Conclusion: Zoledronic acid treatment in elderly patients with primary osteoporosis demonstrates significant efficacy by increasing bone density, improving bone metabolism, enhancing QoL, and exhibiting high safety.

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http://dx.doi.org/10.1007/s10787-025-01683-4DOI Listing

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