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Window of Opportunity — SCE Rheumatology MCQ

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HardRheumatoid ArthritisWindow of OpportunitySCE Rheumatology

A dehydrated 79-year-old with osteoporosis has a Cockcroft–Gault creatinine clearance of 32 mL/min calculated using actual body weight. Annual zoledronic acid has been proposed. What is the appropriate decision?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Do not give Aclasta because creatinine clearance below 35 mL/min is contraindicated

Explanation lettering: B = shown as A · C = shown as B · A = shown as C · E = shown as D · D = shown as E

E is correct. Aclasta is contraindicated when Cockcroft–Gault CrCl is below 35 mL/min, and the osteoporosis dose is not empirically reduced. Hydration reduces renal risk but does not reverse the contraindication. Renal-adjusted oncology zoledronic-acid tables must not be imported into the once-yearly osteoporosis preparation.

Reference: Aclasta 5 mg solution for infusion SmPC: https://www.medicines.org.uk/emc/product/210/smpc