• Posted January 17, 2025

Drug Lowers Fracture Risk in Early Postmenopausal Women

Women past menopause can protect themselves from future fractures through infrequent, cheap IV infusions of a bone-strengthening drug.

Women 50 to 60 who got two IV infusions of zoledronate (Reclast) within five years had a 44% lower risk of spinal fractures, compared to women who received a placebo, according to results published Jan. 15 in the New England Journal of Medicine.

They also had a lower risk of major fractures related to osteoporosis and fragility fractures caused by little to no trauma, results show.

“The results show that prevention of vertebral fractures in early postmenopausal women is possible with very infrequent infusions of zoledronate,” concluded the research team led by Dr. Mark Bolland, an associate professor of medicine with the University of Auckland in New Zealand.

“The cost of the treatment, either to individual patients or to health systems, is likely to be low because the drug is generic and the frequency of administration low,” the team added.

At menopause, women have a 50% lifetime risk of suffering from a fracture, particularly as their bones grow thin and frail through the aging process, researchers said in background notes.

Zoledronate is used to treat or prevent osteoporosis caused by menopause, but it hadn’t been tested to see if early treatment could prevent bone loss in early postmenstrual women, even those with good bone density at the outset, researchers said.

For the study, researchers randomly assigned more than 1,000 women with an average age of 56 to receive either two IV infusions of zoledronate or a placebo.

The women received the infusions at the start of the study, and five years later. They were followed for a total of 10 years to see whether the drug protected their bone health.

Results showed that women who got zoledronate had a 40% lower risk of major fractures from osteoporosis compared to placebo, after 10 years of follow-up.

They also had a 28% lower risk of fragility fractures, which occur due to minimal trauma like a fall, and a 30% lower risk of any fracture.

“Early postmenopausal women who wish to reduce their risk of fracture could consider a strategy involving the administration of zoledronate either every 5 years or every 10 years,” the researchers wrote. 

An editorial accompanying the study said that infrequent zoledronate infusions present “a real opportunity” to help many women avoid fractures.

The findings show that “primary prevention is possible in persons with any bone mineral density, in particular in women who have a sizeable risk of fracture in the foreseeable future and are concerned about this risk,” editorialist Dr. Roland Chapurlat, chief of rheumatology and bone diseases at Edouard Herriot Hospital in Lyon, France, wrote.

“In addition, infrequent doses of generic zoledronate, as used in this trial, will result in a low cumulative dose and minimize both the costs and the side effects of treatment,” Chapurlat concluded.

More information

The Mayo Clinic has more about zoledronate.

SOURCE: New England Journal of Medicine, study, Jan. 16, 2025