Intravenous bisphosphonates
Due to the low adherence to oral bisphosphonates, intravenous bisphosphonates are the first choice.
Zoledronic acid has the strongest evidence, also in age groups > 75 years. Administration of
zoledronic acid to patients with a low-trauma hip fracture 2 weeks or later after surgical repair increases hip BMD, induces significant reductions in the risk of subsequent clinical vertebral,
nonvertebral, and hip fractures, and reduces mortality.
Literature
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Lyles KW, Colón-Emeric CS, Magaziner JS, et al.
Zoledronic Acid in Reducing Clinical Fracture and Mortality after Hip Fracture. N Engl J Med. 2007; 357:1799–1809.
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Boonen S, Black DM, Colón-Emeric CS, et al.
Efficacy and safety of a once-yearly intravenous zoledronic acid 5 mg for fracture prevention in elderly postmenopausal women with osteoporosis aged 75 and older. J Am Geriatr Soc. 2010 Feb;58(2):292–299.
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Eriksen EF, Lyles KW, Colón-Emeric CS, et al.
Antifracture efficacy and reduction of mortality in relation to timing of the first dose of zoledronic acid after hip fracture. J Bone Miner Res. 2009 Jul;24(7):1308–1313.