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Zoledronic acid in the management of osteoporosis: the HORIZON trials

E Michael Lewiecki

Zoledronic acid 5 mg is an annually administered intravenous bisphosphonate that is approved for the treatment of osteoporosis. The Health Outcomes and Reduced Incidence with Zoledronic acid ONce yearly (HORIZON) Pivotal Fracture trial showed an increase in bone mineral density, decrease in bone turnover markers, and signifi cant reduction in the risk of vertebral, hip and other fractures in women with postmenopausal osteoporosis treated over a period of 3 years. The HORIZON Recurrent Fracture Trial demonstrated that an annual infusion of zoledronic acid started within 90 days of surgical repair of a low-trauma hip fracture in women and men was associated with a signifi cant decrease in the risk of new clinical fractures and an increase in survival. The tolerability and safety profi le of treatment in both studies was generally favorable, with the most common adverse event being transient fl u-like symptoms shortly after infusion.