Men's Osteoporosis Support GroupPost-fracture zoledronate J Bone Miner Res. 2009 Mar 3. [Epub ahead of print]. Antifracture Efficacy and Reduction of Mortality in Relation to Timing of First Dose of Zoledronic Acid After Hip Fracture. Eriksen EF and others. PMID: 19257818. This study involved 2127 patients who had surgical repair of a hip fracture. The active treatment group included 1065 and the placebo group 1062 patients. The treatment group got a single 5-mg injection of zoledronate (Reclast) within 90 days of the fracture and followup annual injections thereafter. The authors found, "Analysis by 2w [two-week] intervals revealed a significant total hip BMD response and a consistent reduction of overall clinical fractures and mortality in patients receiving the first dose 2w or later after surgical repair." They continue, "We concluded that administration of zoledronic acid to patients suffering a low-trauma hip fracture 2 weeks or later after surgical repair increases hip BMD, induces significant reductions in the risk of subsequent clinical vertebral, nonvertebral, and hip fractures, and reduces mortality." Editor's comments. These are important results because they show the importance of proper diagnosis and treatment after a hip fracture, or any low-impact fracture for that matter. This 2007 Update has more details on how seldom individuals receive proper therapy after a fragility fracture. The Eriksen and others study highlights the importance of being adequately diagnosed and treated after a fracture, showing that the risk of subsequent fractures is reduced, and, most importantly, there is a reduction in post-fracture mortality. These patients all received zoledronate which has been proven effective when given in a single yearly 5-mg injection. And in last week's Update I highlighted a study which showed that a single injection is actually effective for a total of at least two years. Although this study only tested zoledronate, there is little reason to assume that any other of the FDA-approved bisphosphonates would give different results. The important bottom line from the study is to get adequate diagnosis and, if proven to have osteoporosis, an FDA-approved osteoporosis therapy after a hip fracture to reduce the risk of subsequent fractures and post-fracture mortality. If you or a friend or family member has a low-trauma hip or fracture elsewhere, assume it was due to osteoporosis until proven otherwise. This means a referral to a physician who diagnoses and treats osteoporosis as soon as possible after the fracture occurs. This because the Eriksen and others study has shown the importance and effectiveness of beginning osteoporosis therapy soon after the fracture. Don't assume the orthopedic surgeon is going to make that referral, ask that it be done, preferably right from the hospital bed.
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