HORIZON

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Black DM, et al. "Once-Yearly Zoledronic Acid for Treatment of Postmenopausal Osteoporosis". The New England Journal of Medicine. 2007. 356(18):1809-22.
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Clinical Question

Will a once-yearly infusion of zoledronic acid during a 3-year period significantly reduce the risk of vertebral, hip, and other fractures?

Bottom Line

A once-yearly infusion of zoledronic acid during a 3-year period significantly reduced the risk of vertebral, hip, and other fractures.

Major Points

Bisphosphonates, the most commonly used treatment for established osteoporosis, inhibit osteoclast-mediated bone resorption and reduce the risk of vertebral fracture. Oral bisphosphonates (alendronate and risedronate) have been shown to reduce nonvertebral and hip fractures in women with osteoporosis.However, adherence to oral treatment is problematic due to adherence. Intravenous bisphosphonates have been reported to reduce bone turnover and improve bone mineral density (BMD) for at least 12 months. The HORIZON Pivotal fracture trial, was to determine whether a 5mg infusion zoledronic acid could reduce the risk of vertebral, hip and other types of fractures.

Guidelines

Design

  • international, multicenter, randomized, double-blind, placebo-controlled trial involving postmenopausal women with osteoporosis
  • N=7765
    • 3889 Were assigned to receive zoledronic acid
    • 3876 Were assigned to receive placebo
  • Setting: s
  • Enrollment:
  • Mean follow-up:
  • Analysis:
  • Primary outcome:

Population

Inclusion Criteria

Exclusion Criteria

Baseline Characteristics

Interventions

Outcomes

Primary Outcomes

Secondary Outcomes

Subgroup Analysis

Adverse Events

Criticisms

Funding

Further Reading