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Bisphosphonates generally are prescribed for women with osteoporosis, but fractures are not uncommon in older women with osteopenia. In this randomized trial from New Zealand, 2000 older women (age, ≥65) with osteopenia in at least one hip received either placebo or intravenous zoledronate, given every 18 months for 6 years. All participants also received vitamin D supplementation. At baseline, mean age was 71, and mean bone density T scores were −1.26 (total hip) and −1.64 (femoral neck).
The proportion of women with fragility fractures (fractures excluding hands, feet, skull, facial bones, but including asymptomatic radiographic vertebral fractures) was significantly lower in the zoledronate group than in the placebo group (12% vs. 19%). Z…