Table 1.

Summary of fracture data among bisphosphonates

Reduction in radiographically defined fractures in PROSPECTIVE clinical studies	Risedronate (Actonel)	Alendronate (Fosamax)	Ibandronate (Boniva)	Zoledronic acid (Reclast)
Vertebral fractures
1 Year vertebral	65% VERT-NA – Harris, JAMA 1999 61% VERT-MN – Reginster, Osteoporosis International 2000	Not Reported – Lieberman, NEJM 1995	Not Measured – BONe – Chesnut, ABMR 2004	60% – HORIZON – Black, NEJM 2007
3 Year vertebral	41% – VERT-NA- Harris, JAMA 1999	47% – FIT 1 – Black, Lancet 1996	62% -BONE – Chesnut, ABMR 2004	70% – HORIZON – Black, NEJM 2007
4 Year vertebral	n/a	44% – FIT 2 –Cummings, JAMA 1998	n/a	n/a
Nonvertebral fractures
3 Year Nonvertebral	39% – VERT NA 20% – HIP NS – 33% – VERT-MN – Reginster – Osteoporosis International 2000	NS – 21% – Lieberman NS – 20% – FIT 1 – Black, Lancet 1996	NS – 10%-BONE –Chesnut, ABMR 2004	25% – HORIZON – Black, NEJM 2007
4 Year Nonvertebral	n/a	NS – 12% – FIT 2 – Cummings, JAMA 1998	n/a	n/a
5 Year Nonvertebral	37% VERT MN extension	n/a	n/a	n/a
Hip fractures
Hip Fracture Primary Endpoint?	Yes	No	No	Yes
Hip Fractures	60% HIP- McClung, NEJM 2001 – Group 1 – Reduction in patients with confirmed osteoporosis and at least one prevalent fracture at baseline NS – 20% HIP, McClung, NEJM 2001 – Group 2- Patients not selected on basis of low BMD	51% FIT 1 Black, Lancet 1996- Reduction in patients with confirmed osteoporosis and at least one prevalent fracture at baseling *(This data is based on 33 fractures: 22 in the placebo and 11 in the treatment group. If one more patient fractured in the treatment group, this 51% would be NONstatistically significant) NS – 21% FIT 2 Cummings, JAMA 1998 (0.43 1.44) p = 0.44 – patients not selected based on osteoporotic BMD	n/a	41% – HORIZON – Black, NEJM 2007