Decreased nonvertebral fracture incidence with zoledronate use for >3 years: post hoc analysis of a Randomized Controlled Trial
Authors' conclusion
These findings suggest that the efficacy for non-vertebral fracture prevention of anti-resorptive drugs has been underestimated because of the short-term evaluation of their effects.
Study context
- Population
- Osteopenic women aged >65 yr (Auckland zoledronate RCT)3.6% withdrew or lost to follow-up
- Participants
- 2,000 women
- Comparison
- Zoledronate every 18 mo vs placebo
- Primary endpoint
- Non-vertebral fracture rates, years 1-3 vs years 4-6 (excluding fractures of hands, feet and face)
- Follow-up
- Years 1-3 and years 4-6
Methodological detailsplacebo-controlled, 6-yr
- Placebo-controlled
- 6-yr
Primary result
As reported in the abstract
Non-vertebral fracture rate per 1000 women-years
Each group vs placeboEstimate (CI)P value
Zoledronate
rate ratio (years 1-3) 0.83(0.60–1.14)
Zoledronate
rate ratio (years 4-6) 0.40(0.27–0.58)
between-period comparison, p < .05Further findings
Events
| Outcome | Zoledronate | Placebo |
|---|---|---|
| Non-vertebral fractures, total count (excluding hands, feet, face) · 6 yr | 108 | 178 |
Total fragility fractures (incl. vertebral), rate ratio
- Rate ratio, years 1-3
- 0.76 (95% CI 0.56, 1.02)
- Rate ratio, years 4-6
- 0.39 (95% CI 0.29, 0.53)
- Similar pattern to non-vertebral fractures
Original publication
Decreased nonvertebral fracture incidence with zoledronate use for >3 years: post hoc analysis of a Randomized Controlled Trial. J Bone Miner Res. Published 22 January 2026. doi:10.
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