Use of intravenous zoledronate after hip fracture

Use of intravenous zoledronate after hip fracture

Intravenous zoledronate reduces refracture risk by a third but the use of this treatment is highly variable.

Members of the Hip Fracture Audit and the Secondary Prevention advisory groups of the Global Fragility Fracture Network have developed a consensus paper regarding the use of zoledronate after hip fracture. This paper provides guidance from expert consensus, aiming to assist orthogeriatricians, pharmacists and health services managers establish local protocols to deliver this highly clinically and cost-effective treatment to patients before they leave hospital.

The aspects discussed are the following:
• Vitamin D status and vitamin D loading regimes
• Renal function and the safety, dose and speed of zoledronate infusions
• Dental issues and extremely low risk of osteonecrosis of the jaw
• Timing of infusion, no need to wait 2 weeks and risk of non-union
• How big a dose of IV Zol is needed?
• How often does IV Zol need to be given?

A Call to Action by the authors!
We invite all those looking after patients with hip fracture to ask not ‘should I give IV Zol?’, but ‘why wouldn’t I give IV Zol?’, and to set up pragmatic local pathways of care to effect this best practice.

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