Intravenous Bisphosphonate Therapy for Postmenopausal Women with Low Bone Mass

Oral bisphosphonate therapy prevents BMD loss in postmenopausal women, but long-term adherence is poor. In a 2-year industry-supported trial, 581 postmenopausal women (mean age, 60; 93% white) with low BMD were randomized to one of three regimens: 5-mg infusion of zoledronic acid (Reclast) at baseline and at month 12; zoledronic acid infusion at baseline and placebo at month 12; or placebo at baseline and month 12. Low BMD was defined as BMD T-score <–1.0 and >–2.5 at the lumbar spine and >–2.5 at the femoral neck.

At 24 months, mean spinal BMD was substantially higher, relative to baseline, among women in the single-dose (4.4% change) and two-dose (5.2% change) treatment arms than in the placebo arm (–1.31% change). Increases in BMD at the …