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Fracture Prevention with Infrequent Zoledronate in Women 50 to 60 Years of Age
Article Number: SIS651274AI210525
21st May, 2025
Author(s):
Mark J. Bolland, M.B., Ch.B., Ph.D.; Zaynah Nisa, B.Nurs.; Anna Mellar, B.Sc.; Chiara Gasteiger, Ph.D.; Veronica Pinel, M.D.; Borislav Mihov, B.Phty.; Sonja Bastin, M.B., Ch.B.; Andrew Grey,
Abstract:
Zoledronate has demonstrated efficacy in fracture prevention for older women with osteoporosis, but its prolonged effects on bone turnover suggest that less frequent dosing may be sufficient. This 10-year, randomized, placebo-controlled trial evaluated whether infrequent zoledronate administration could prevent vertebral fractures in early postmenopausal women. Participants aged 50 to 60 years with bone mineral density T scores between 0 and -2.5 were randomized into three groups: zoledronate at baseline and 5 years, zoledronate at baseline and placebo at 5 years, and placebo at both time points. The primary endpoint was morphometric vertebral fracture, defined by a 20% reduction in vertebral height. At 10 years, zoledronate significantly reduced the risk of vertebral fractures compared to placebo, with a relative risk reduction of approximately 40%. Secondary analyses showed reductions in fragility, major osteoporotic, and overall fractures. Bone mineral density remained stable in zoledronate-treated groups, and markers of bone turnover remained suppressed. Findings suggest that infrequent zoledronate administration provides long-term protection against fractures and bone loss in early postmenopausal women, offering a viable alternative to more frequent dosing regimens.