Zoledronic acid and fracture prevention in early postmenopausal women

Full Stage Lay Summary Fractures are a major health problem occurring in >50% of older women. Low bone density is a strong risk factor for fracture, but 80% of fractures occur in women with only mild reduction in bone density. We plan to investigate whether zoledronate, an effective osteoporosis treatment, can be given very infrequently by injection to prevent bone loss and spinal fractures in women with normal or only mildly low bone density. We will undertake a 10 year clinical trial in early post-menopausal women with normal or mildly low bone density. Zoledronate or an inactive agent (placebo) will be administered every 5 years. The main outcomes are occurrence of new spinal fractures and changes in bone density. If the treatment is effective, the study will offer a new, more convenient approach to preventing fractures, and potentially a much higher proportion of fractures could be avoided than with current strategies.