Zoledronic acid adminstered every three months is ineffective for the prevention of bone metastases in patients with high-risk prostate cancer (PCa), according to a recent study published in European Urology.

Researchers led by Manfred Wirth, MD, of the University Clinic Carl Gustav Carus in Dresden examined 1,393 patients who had PSA levels of 20 ng/nL or greater, node-positive disease, or a Gleason score of 8 to 10 in order to determine the effects of zoledronic acid in this population.

“Zoledronic acid significantly reduces the incidence of skeletal complications in castration-resistant metastatic PCa versus placebo,” they noted.

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They randomized these men to either standard therapy alone or combined with 4 mg of zoledronic acid every 3 months for at least 4 years. Median follow-up was 4.8 years.

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Using a Kaplan-Meier estimated proportion, the researchers found rate of bone metastases to be 14.7 percent in the zoledronic group and 13.2 percent in the control.

“Zoledronic acid administered every three months was demonstrated to be ineffective for the prevention of bone metastases in high-risk non-metastatic PCa patients at 4 years,” the authors concluded.


  1. Wirth, Manfred, et al. “Prevention of Bone Metastases in Patients with High-risk Nonmetastatic Prostate Cancer Treated with Zoledronic Acid: Efficacy and Safety Results of the Zometa European Study (ZEUS).” European Urology. DOI: 10.1016/j.eururo.2014.02.014. March 2015.