Single annual injectable treatment for postmenopausal osteoporosis.
BACKGROUND
Several treatments for postmenopausal osteoporosis have become available over the last decade, but adherence to treatment is inadequate and the prevention of non-vertebral fracture by those medications is still modest.


METHODS
We have performed a literature search regarding treatment with zoledronic acid in postmenopausal women.


RESULTS
In the Reduced Incidence with Zoledronic Acid Once Yearly (HORIZON) Pivotal Fracture Trial, involving 7765 postmenopausal women with low bone mineral density or with prevalent vertebral fracture, women taking zoledronic acid had a 70% vertebral fracture relative risk reduction and a 41% relative risk reduction for hip fracture, at 3 years, compared to placebo. In the HORIZON Recurrent Fracture Trial, 2127 patients (76% were women) were randomized to receive either zoledronic acid or a placebo after sustaining an initial hip fracture. After a median follow-up of 1.9 years, a relative risk reduction of 35% of clinical fractures was observed. Death from all causes was reduced by 28% in the zoledronic acid group. Zoledronic acid was generally safe in those trials, although a slightly increased rate of severe atrial fibrillations was observed in the HORIZON Prevention Fracture Trial, although not in the HORIZON Recurrent Fracture Trial. The clinical significance of this remains unclear.


CONCLUSIONS
Yearly zoledronic acid presents a new option for the treatment of postmenopausal osteoporosis, with the perspective of improving the long-term persistence of therapy because of its once-a-year regimen.
Chapurlat
Roland D
RD
Rheumatology Université de Lyon, INSERM U831, Department of Orthopedics and Rheumatology, Hôpital E Herriot, Hospices Civils de Lyon, 69437 Lyon Cedex 03, France. chapurlat@lyon.inserm.fr
D000818:Animals; D050071:Bone Density Conservation Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003692:Delayed-Action Preparations; D004164:Diphosphonates / Q000008:administration & dosage* / Q000627:therapeutic use*; D050723:Fractures, Bone / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage / Q000627:therapeutic use; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy* / Q000473:pathology; D055502:Secondary Prevention; D000077211:Zoledronic Acid
D050071:Bone Density Conservation Agents; D003692:Delayed-Action Preparations; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid