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Zoledronic Acid Lowers Fracture Rates and Mortality After Hip Fracture
Annual infusion of the bisphosphonate zoledronic acid is associated with reduced secondary fractures and lowered mortality, according to an industry-funded, international study.
The trial, published online in the New England Journal of Medicine, studied some 2100 older patients who had recently undergone surgical repair of a hip fracture and who "were unable or unwilling to take an oral bisphosphonate." Patients were randomized to receive either annual infusions of zoledronic acid or placebo. After a median follow-up of almost 2 years, the treatment group experienced a lower rate of new clinical fractures — both vertebral and nonvertebral — than the control group. Mortality was also lower with zoledronic acid, showing a 28% relative risk reduction.
Editorialists write that the outcome "was striking and clearly establishes the need for pharmacologic intervention" after hip fracture. However, they continue, "there is no reason to believe that [these effects] are unique to zoledronic acid or bisphosphonates in general."
LINK(S):
NEJM article (Free)
NEJM editorial (Free)
Published in Physician's First Watch September 18, 2007
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