A clinician's perspective on the use of zoledronic acid in the treatment of postmenopausal osteoporosis.

Osteoporotic fractures may lead to pain, disability, impaired quality of life, and increased risk of death, with annual health-care costs of $17 billion or more. Oral bisphosphonates, the first-line treatment for postmenopausal osteoporosis (PMO), increase bone mineral density and reduce the risk of fracture, but dosing requirements are complex and compliance and persistence are poor. The newest bisphosphonate treatment option, intravenous (IV) zoledronic acid (ZOL) every 12mo, has been shown to reduce the risk of vertebral, hip, and other nonvertebral fractures. Long-dosing intervals and 100% bioavailability with IV bisphosphonate therapy address some of the limitations associated with oral bisphosphonates. This is a review of the clinical trial data supporting the use of IV ZOL to reduce fracture risk, and its potential role in the management of PMO in clinical practice.