Researchers from New Zealand have recently reported the results of a large trial involving 2000 women with osteopenia (T score of −1.0 to −2.5 at either the total hip or the femoral neck on either side), examining the role of intravenous intermittent zolendronate 5 mg IV every 18 months in preventing fractures amongst older women. Those in the active treatment arm of the study received four infusions zoledronate, and a dietary calcium intake of 1000 mg per day was advised for all participants (calcium supplements were not provided). Participants who were not already taking vitamin D supplements received cholecalciferol before the trial began (a single dose of 2.5 mg) and during the trial (1.25 mg per month). The primary end point was the time to first occurrence of a non-vertebral or vertebral fragility fracture. At baseline, the mean T score at the femoral neck was −1.6±0.5, and the median 10-year risk of hip fracture was 2.3%. A fragility fracture occurred in 190 women in the placebo group and in 122 women in the zoledronate group (hazard ratio with zoledronate, 0.63; 95% confidence interval, 0.50 to 0.79; P<0.001). Women who received the bisphosphonate had a lower risk of non-vertebral fragility fractures (hazard ratio, 0.66; P=0.001), symptomatic fractures (hazard ratio, 0.73; P=0.003), vertebral fractures (odds ratio, 0.45; P=0.002), and height loss (P<0.001). No atypical femoral fractures or cases of osteonecrosis of the jaw were reported during the trial.