This page shows what was measured, who it was measured in, and what that does not settle.
What Zoledronic Acid Anhydrous does in the body
Cells that dissolve bone take it in as they work, and it shuts down an enzyme they need, so they stop and die.
The drug is dripped into a vein once a year, so none of it is lost to the gut. It spreads through the blood and sticks to bone mineral everywhere in the skeleton. One infusion suppresses bone breakdown for about a year because the drug stays bound to the mineral it is waiting in.
Why people take it. Fragile bones, and the bone damage caused by some cancers — two different products with the same active drug
What happened in people
Hip fracture 1.4% against 2.5% over three years in 7765 patients, hazard ratio 0.59 (95% CI 0.42 to 0.83)
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The recorded finding that sits closest to something a person would notice. Written into the record, not signed off, and it carries no population or interval.
The only agent in this file with a randomised all-cause mortality signal, and the only one whose own trial found significantly more serious atrial fibrillation
Where it acts
The resorption surface of bone throughout the skeleton, reached directly through the bloodstream rather than through the gut
Kind of result
The kind of result is not recorded
Supervision
Professional supervision is normally required. A regulator classifies this substance in a way that restricts how it is supplied.
What the registries record it as
The substance registry classes this as chemical.
FDA substance registry · 6XC1PAD3KF · read 2026-08-29
Its recorded molecular formula is C5H10N2O7P2•H2O.
US prescribing information · 20cd29cc-cef5-48c4-adfe-6b3dfee0ab61 · read 2026-08-30
Where each sentence above came from
A person wrote this explanation into the record, with the studies named in the path below.
The recorded use, written for a reader without medical training. Not signed off.
A limit recorded against this substance. Not signed off as a reviewed claim.
The four opening statements run to 119 words.
Words this page uses
Four words worth knowing first
Chosen from what this page shows, with each one explained before the word it depends on.
Stand-in result
A stand-in result is a number measured because the real result takes too long.
A picture of it, and where the picture fails
It is like judging a journey by the speedometer rather than by arriving.
Where that stops being true. Speed does predict arrival. Many stand-in results do not predict the real one.
What people get wrong. A stand-in result is often reported as the result itself.
A surrogate endpoint substituted for a clinical endpoint, valid only where the substitution has been shown to hold.
Randomisation
Randomisation means chance decides who gets which treatment.
A picture of it, and where the picture fails
It is like a coin toss deciding the groups.
Where that stops being true. A coin toss is fair once. Fairness here comes from doing it for everyone.
What people get wrong. It is thought to make groups identical. It makes them similar on average, including on things nobody measured.
Allocation of participants to arms by a chance process, so that unmeasured factors are balanced in expectation.
Confidence interval
A confidence interval is the range the true answer is likely to sit in.
A picture of it, and where the picture fails
It is like a weather forecast giving a range rather than one number.
Where that stops being true. A forecast range covers tomorrow. This one covers what the study could resolve.
What people get wrong. The middle number is read as the answer. A range crossing zero means no change is still possible.
An interval estimate that would contain the true parameter in a stated proportion of repeated studies.
Pathway
A pathway is a chain of steps inside a cell, each one setting off the next.
A picture of it, and where the picture fails
A pathway is like a row of dominoes.
Where that stops being true. Dominoes fall one way. Pathways loop back and can switch themselves off.
What people get wrong. Changing one step is read as changing the outcome. Other steps often absorb it.
An ordered series of molecular interactions producing a defined cellular change.
What happened in people◇Read from sources, not yet reviewed
What was measured, goal by goal
One row for each goal a registered study measured something for. One column for each kind of thing that could be measured.
Registered studies list 40 outcome measures that RNAWiki could read. A registered study says what someone planned to measure. It does not say what they found. 0 of the matched studies tested this substance, and 0 posted a result.
There is no single score. A strong test result and a weak life result are different facts.
Goals down the side, kinds of measurement across the top. Each cell says what kind of thing was registered, not what was found.
Goal
Life outcome
What a body can do
How a person feels
A test result
A step in the body
Harms
How long
Who was studied
Pain
∅Nothing in the sources checkedNo registered study lists a life outcome for this goal.
∅Nothing in the sources checkedNo registered study lists a performance measure for this goal.
…Waiting for a reviewer1 registered symptom measure.
∅Nothing in the sources checkedNo registered study lists a test result for this goal.
∅Nothing in the sources checkedNo registered study lists a body-step measure for this goal.
—Not recordedHarms were not a registered measure for this goal.
—Not recordedNo finished study window is recorded.
…Waiting for a reviewerWho was studied is listed further down the page.
Healthy ageing
…Waiting for a reviewer1 registered study measure of this kind. No reviewed result yet.
∅Nothing in the sources checkedNo registered study lists a performance measure for this goal.
∅Nothing in the sources checkedNo registered study lists a symptom measure for this goal.
∅Nothing in the sources checkedNo registered study lists a test result for this goal.
∅Nothing in the sources checkedNo registered study lists a body-step measure for this goal.
—Not recordedHarms were not a registered measure for this goal.
—Not recordedNo finished study window is recorded.
…Waiting for a reviewerWho was studied is listed further down the page.
Which registered measures put each goal on this table
Pain
pain reduction
Healthy ageing
prostate cancer specific mortality
Sorted by fixed word lists, version v1. A name the rules do not recognise stays unsorted rather than moving to the nearest column.
What each mark on this table means
∅ Nothing in the sources checked
No registered study lists a life outcome for this goal.
… Waiting for a reviewer
1 registered symptom measure.
— Not recorded
Harms were not a registered measure for this goal.
What happened in people◇Read from sources, not yet reviewed
What happened in people
Each card is one study: the exact question it asked, who was in it, and whether it showed what it set out to show.
Co-primary: new morphometric vertebral fracture, and hip fracture, over 36 months
Vertebral 3.3% against 10.9%, RR 0.30 (95% CI 0.24 to 0.38); hip 1.4% against 2.5%, HR 0.59 (0.42 to 0.83)
Repeated elsewhere
Replicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. Serious atrial fibrillation occurred in 50 patients against 20 on placebo, P<0.001. This was an unanticipated finding and is not in the headline result.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Intravenous infusion, 5 mg over at least 15 minutes, once yearly for osteoporosis
Interval reported. 95% CI 0
Written into the record, not signed off as a reviewed claim.
8.6% against 13.9%, a 35% reduction, P=0.001; all-cause mortality 9.6% against 13.3%, P=0.01
Repeated elsewhere
Unreplicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. The mortality result was a safety-analysis finding, not a prespecified efficacy endpoint. It is frequently quoted as though it were the trial’s primary result.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Intravenous infusion, 5 mg over at least 15 minutes, once yearly for osteoporosis
Interval reported. Not recorded in this summary
Written into the record, not signed off as a reviewed claim.
RNAWiki holds 3 written-up human studies for this substance, each with the question it asked.
How we know it
Each card names the study, the number of people and what the study set out to measure.
What this does not prove
These summaries were written by a person and have not been signed off as reviewed claims.
Why it matters
A study that failed is as informative as one that worked, and both are here.
What we still do not know
No reviewed claim exists, so no exact population, effect size or interval is published yet.
What happened in people◇Read from sources, not yet reviewed
How close this is to real life
The top step is something a person would feel or care about. The bottom is a guess from software. Filled steps are where evidence exists for this substance.
■Living longer, or avoiding a major eventEvidence recorded. Death, a heart attack, a stroke, a hospital stay.11 registered measures of this kind. No reviewed result.
□What a body can do day to dayNo evidence recorded. Walking, dressing, breathing, recovering.No registered study measures this.
□Measured performanceNo evidence recorded. How much was lifted, how far was run, how fast.No registered study measures this.
■Symptoms and quality of lifeEvidence recorded. Pain, tiredness, mood, sleep, as the person rated it.1 registered measure of this kind.
■A number that stands in for healthEvidence recorded. Cholesterol, blood sugar, bone density. A stand-in, not the thing itself.8 registered measures of this kind.
■A step measured inside a personEvidence recorded. Something measured in human tissue or human cells.A human record sits on the stored organism ladder.
■AnimalsEvidence recorded. Mice, rats, dogs. Useful for ideas, not proof about people.Stored records in C. elegans (roundworm), Mouse, Rat. A result in animals says what to test next. It does not say what happens in people.
■Cells in a dishEvidence recorded. Cells or chemistry on a bench, far from a whole body.Stored mechanism abstracts describe steps measured in cells or tissue.
□A guess from softwareNo evidence recorded. Nobody measured it. RNAWiki never publishes one as a finding.RNAWiki stores no prediction for this record. Software can suggest a link. RNAWiki does not publish one as a finding.
Higher on these steps means closer to something a person would feel. It does not mean better done.
What it changes in the body◇Read from sources, not yet reviewed
The path through the body
From what a person takes to what changes. A solid line is a step measured in people. A dashed line is a step nobody has measured that way.
Start
Zoledronic Acid Anhydrous
What a person takes: Intravenous infusion, 5 mg over at least 15 minutes, once yearly for osteoporosis.
The measurement behind this step
Given in a clinic or infusion unit. The route exists to solve the absorption problem: oral bisphosphonates deliver under 1% of a tablet, and about half of people prescribed one have stopped within a year. An infusion also cannot be undone, which is the trade in the other direction.
Getting in
Infused into a vein, so absorption is not a variable
The whole dose goes straight into the blood over about fifteen minutes. There is nothing to swallow, nothing to absorb and no interaction with breakfast.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
A single 5 mg dose is given over no less than 15 minutes. The label caps a single dose at 5 mg and requires creatinine clearance before each dose, because the drug is not metabolised and is cleared unchanged by the kidney, so renal impairment converts directly into higher and longer exposure.
It binds bone mineral across the whole skeleton within hours
From the blood it goes to bone and sticks. The rest is passed in urine within a day. What is left in the body is almost entirely in the skeleton.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
The geminal P-C-P group chelates calcium in hydroxyapatite, and zoledronic acid has the highest mineral affinity of the marketed bisphosphonates. That affinity, more than its enzyme potency, is what makes a yearly interval possible: the drug is not cleared from bone, it waits there.
The acid a demolition cell uses to dissolve bone is also what unsticks the drug. The cell then takes it in along with the dissolved mineral.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Acidification of the sealing zone to about pH 4.5 desorbs the bisphosphonate, which enters the osteoclast by fluid-phase endocytosis. Because release is driven by resorption, the delivered dose scales with how active the cell is — the drug is concentrated on exactly the cells doing the damage.
Inside, the drug jams the enzyme that makes the lipid tags several of the cell’s control proteins need. The cell loses its digestive surface, then dies.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Inhibition of farnesyl diphosphate synthase depletes farnesyl and geranylgeranyl diphosphate, leaving Rab, Rho and Rac GTPases unprenylated. Vesicle trafficking and cytoskeletal organisation fail, the ruffled border is lost, and toxic accumulation of unprenylated substrates and of an ATP analogue drives osteoclast apoptosis.
Bone turnover stays suppressed for about a year from one dose
A single infusion holds bone breakdown down for roughly twelve months, which is why it is given once a year.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Bone resorption and formation markers fall within days and remain suppressed for about twelve months, because the reservoir bound to mineral keeps being released as resorption proceeds. The dosing interval is set by that marker curve; the fracture evidence comes separately, from the three annual infusions given in HORIZON-PFT.
Fewer fractures, and in one trial fewer deaths that fractures do not explain
Hip fractures fell by 41% in the osteoporosis trial. In the trial run straight after a hip fracture, deaths from any cause fell by 28%, and preventing further fractures accounted for only a small part of that.
──Measured in people. Written by a person from the study named beside the step. Not signed off as a reviewed claim.
The measurement behind this step
HORIZON-PFT: hip fracture hazard ratio 0.59 (95% CI 0.42 to 0.83). HORIZON-RFT: all-cause mortality 9.6% against 13.3%, P=0.01. The mediation analysis attributed 8% of the mortality effect to prevented fractures and found treated patients less likely to die of pneumonia and arrhythmia, with the death benefit disappearing after adjustment for acute intercurrent events. No mechanism has been established.
No suggested links are held for this record, so nothing is hidden from this path.
What we know
The record describes 6 steps from taking it to an effect in a person.
How we know it
Each step names the study behind it in the technical detail beside it.
What this does not prove
A change inside the body is a reason to look. It is not a result in a person.
Why it matters
A reader can see exactly where the chain stops being measured in people.
What we still do not know
No reviewed claim binds any of these steps to a named population.
What it would be like to take◇Read from sources, not yet reviewed
Felt, measured, or meaningful
Three different things that get called the same word. Registered studies measured all three, and mixing them is how a blood test becomes a health claim.
Felt
Things a person could notice without a test.
pain reduction
Measured
Things only a test, a scale or a device shows.
bone mineral density in the lumbar spine
lumbar spine bone mineral density
bone mineral density
bone mineral density from baseline to month 36
bone mineral density t from baseline to 12 months
liver function
urine n telopeptide of type 1 collagen
lumbar spine bone mineral density at week 52
Meaningful
Things that change how a life goes, not only a number.
progression free survival
disease progression
disease free survival
days of progression free survival
prostate cancer specific mortality
overall survival
freedom from any bone fracture rate at three years
disease free survival in premenopausal
time to disease progression
event free survival
and 1 more.
A registered study says what someone planned to measure. It does not say what they found. A number moving is not the same as a life going better. The two are shown apart here.
Felt, but not shown to help. A person notices a change. No study showed it leads anywhere good.
Measured, but not felt. A number moves. The person notices nothing. Both can be true.
Measured, but not shown to matter. A number moves in the good direction. Nobody showed that lives went better.
Matters, but takes years. The result that counts may take longer than anyone would keep watching.
Names that fit none of the three (20)
confirmed response
time to first skeletal related event
best response
bone density
lumbar spine bmd after 12 months of letrozole therapy
toxicity
maximum tolerated dose
response rates of vad vs thalidomide/dexamethasone
pet ct
time to first on study skeletal related event
time to the first on study sre
time to the first on study skeletal related event
t from baseline to month 36
z from baseline to month 36
time to development of a malignant skeletal related events
renal function
who experienced an adverse event
who discontinued treatment due to an ae
fractures
safety
These are harms, study-process measures, or names the rules did not recognise. They are shown rather than dropped.
What it would be like to take◇Read from sources, not yet reviewed
How long anything takes
Nine different lengths of time that get confused with each other. None of them is worked out from another.
Before anything is noticed.RNAWiki does not store this separately, and never works it out from another figure on this page.
Before a test result moves.RNAWiki does not store this separately, and never works it out from another figure on this page.
Before performance moves.RNAWiki does not store this separately, and never works it out from another figure on this page.
How long the result was watched.No finished study window is recorded for a study that tested this substance.
How long people took it.How long people actually took it is not stored. The study window is not the same thing.
How long people were followed.Follow-up length is not stored separately. It is never read off the study window, which would be a different thing.
How fast the body clears it. 146 hours hours
Read from the label, which states: “The terminal elimination phase of zoledronic acid was prolonged, with very low concentrations in plasma between Days 2 and 28 postinfusion, and a terminal elimination half-life t 1/2γ of 146 hours.”
How long effects linger.RNAWiki does not store this separately, and never works it out from another figure on this page.
Beyond the studies. Nothing is recorded about the long term.
The longest finished study sets the edge of what anyone measured.
A study window is not how long people took it, and neither is how long they were followed. Where RNAWiki holds only one of the three, it shows one.
What is missing or unclear◇Read from sources, not yet reviewed
Were people like you studied?
RNAWiki cannot tell whether a study fits you. It can show who was in it, and where the result stops carrying.
Who was studied
People similar to this profile were included.
Postmenopausal women with osteoporosis, men with osteoporosis, people on long-term glucocorticoids, people with Paget disease, and, at a different dose under a different brand, people with cancer in bone.
Who is missing from the studies
Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
What the label states about particular groups
On pediatric, the label states: “The safety and effectiveness of zoledronic acid was studied in a one-year, active-controlled trial of 152 pediatric subjects (74 receiving zoledronic acid).”
US prescribing information · 20cd29cc-cef5-48c4-adfe-6b3dfee0ab61 · read 2026-08-30
On older people, the label states: “Clinical studies of zoledronic acid in hypercalcemia of malignancy included 34 patients who were 65 years of age or older.”
US prescribing information · 20cd29cc-cef5-48c4-adfe-6b3dfee0ab61 · read 2026-08-30
On people who are pregnant, the label states: “Risk Summary Based on findings from animal studies and its mechanism of action, zoledronic acid can cause fetal harm when administered to a pregnant woman [see Clinical Pharmacology (12.1) ] .”
US prescribing information · 20cd29cc-cef5-48c4-adfe-6b3dfee0ab61 · read 2026-08-30
On people who are breastfeeding, the label states: “Risk Summary After administration of zoledronic acid, it is not known whether zoledronic acid is present in human milk, or whether it affects milk production or the breastfed child.”
US prescribing information · 20cd29cc-cef5-48c4-adfe-6b3dfee0ab61 · read 2026-08-30
Where the result stopped carrying
Serious atrial fibrillation appeared unanticipated in the pivotal trial and was later confirmed as a class-level pooled signal, OR 1.40 (95% CI 1.02 to 1.93)
The acute-phase reaction — fever, myalgia, headache, arthralgia, limb pain — affects more than one in ten and is the usual reason a second infusion is declined
Renal clearance of an unmetabolised drug forced a labelled dose cap, a minimum infusion time and creatinine clearance measurement before every dose
Osteonecrosis of the jaw and atypical femoral fracture were added as class warnings after approval, not found in the registration programme
This is a scope explorer, not a diagnosis engine.
It shows who was studied so you can see whether people similar to you were included.
RNAWiki cannot tell whether a study fits you. It can show who was in it.
What it would be like to take◇Read from sources, not yet reviewed
Why it might seem to do nothing
A real effect and a noticed effect are different things. These are the recorded reasons the two come apart.
It was studied for a different goal
The studies measured something else entirely.
On this record: Some registered studies measured things that match no goal on this page.
It was studied in different people
The people in the studies were not much like the reader.
On this record: Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
The evidence may simply be wrong
Small early studies often do not hold up.
On this record: RNAWiki has not yet published a reviewed conclusion for this use.
Other reasons RNAWiki checked and found nothing for (10)
A different form was studied
The studied form is not the form on the shelf. Nothing in this record points to this reason.
There was nothing to correct
Where a level is already normal, topping it up may change nothing. Nothing in this record points to this reason.
Something else had to happen too
In the studies it was paired with training, a diet or another treatment. Nothing in this record points to this reason.
The change is too small to feel
A real change can still sit below what a person notices. Nothing in this record points to this reason.
Day-to-day swing hides it
Sleep, food, stress and time of day move most numbers more than this would. Nothing in this record points to this reason.
Not enough time yet
The studies ran longer than the person has waited. Nothing in this record points to this reason.
It was not taken as studied
Missed days change the result, and studies count them. Nothing in this record points to this reason.
Something else changed at the same time
Two changes at once cannot be told apart afterwards. Nothing in this record points to this reason.
The product may not be what it says
Contents of a sold product are not always what the label states. Nothing in this record points to this reason.
No recorded reason
RNAWiki has nothing stored that would explain it. Nothing in this record points to this reason.
None of these is a reason to take more. Taking more is not a step this page ever suggests.
What it would be like to take◇Read from sources, not yet reviewed
What taking it involves
The recorded facts about getting hold of it and using it. Nothing here is a suggestion about what you should do.
How it is supplied
Given by a clinician
❝ Quoted from a source
Where this came from
Copied from a source RNAWiki stored, with the source named.
Read from the recorded approval status.
No source is stored against this line.
Form and route
Intravenous infusion, 5 mg over at least 15 minutes, once yearly for osteoporosis
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The form and route recorded on this substance.
No source is stored against this line.
Who oversees it
Professional supervision is normally required. A regulator classifies this substance in a way that restricts how it is supplied.
❝ Quoted from a source
Where this came from
Copied from a source RNAWiki stored, with the source named.
Suppression classes recorded: S3.
No source is stored against this line.
What is in the pack
Given in a clinic or infusion unit. The route exists to solve the absorption problem: oral bisphosphonates deliver under 1% of a tablet, and about half of people prescribed one have stopped within a year. An infusion also cannot be undone, which is the trade in the other direction.
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
Recorded notes on how this is sold and what that means for what is in the pack.
No source is stored against this line.
Where it is registered
Regulatory records are listed in the technical disclosure at the foot of this page.
# Counted from records
Where this came from
A count of rows RNAWiki holds. It describes our records, not your body.
Register entries are stored per jurisdiction and shown with their dates.
No source is stored against this line.
Why people stop
Not recorded.
∅ Nothing recorded
Where this came from
RNAWiki holds nothing here and says so rather than guessing.
No record of why people stopped taking it is stored for this substance.
No source is stored against this line.
What it would be like to take◇Read from sources, not yet reviewed
What can go wrong
Sorted by where each line came from. A regulator's label and a report somebody sent in are not the same kind of fact.
·Worth asking a clinician aboutWritten into the record from the studies named on this page
No boxed warning. Most common reactions above 10% are pyrexia, myalgia, headache, arthralgia and pain in extremity, concentrated after the first infusion. Labelled warnings cover hypocalcaemia, renal toxicity with a 5 mg single-dose cap and a minimum 15-minute infusion with creatinine clearance checked before each dose, osteonecrosis of the jaw, atypical femoral fracture, and severe bone, joint or muscle pain for which future doses are withheld. Serious atrial fibrillation occurred in 50 against 20 patients in HORIZON-PFT; rates of atrial fibrillation and stroke were similar between groups in HORIZON-RFT. Patients receiving Zometa must not receive Reclast.
Nobody counted how many people took this and were fine, so this cannot be turned into a rate.
These are reports people sent to a regulator. They do not show the medicine caused the reaction.
Nobody counted how many people took the medicine and reported nothing.
The same event can be reported more than once, and many reports are incomplete.
News coverage, lawsuits and new warnings change how often people report.
A count is not a rate and not a risk.
Zoledronic Acid Anhydrous appears in spontaneous reports to regulators. Across the 10 most-reported reaction terms, 22089 reaction mentions were counted. One report can name several reactions.
The recorded terms (10)
osteonecrosis of jaw — 5228 reaction mentions
osteonecrosis — 4264 reaction mentions
pain — 2309 reaction mentions
pyrexia — 2049 reaction mentions
arthralgia — 1765 reaction mentions
bone disorder — 1515 reaction mentions
pain in jaw — 1345 reaction mentions
tooth extraction — 1301 reaction mentions
myalgia — 1161 reaction mentions
osteomyelitis — 1152 reaction mentions
open-targets-adr · recorded 2026-06-24 · a recorded source, not a stored snapshot
Over a long time. No completed tested study window is recorded, so long-term effects are not established by the registry record.
Groups the studies covered thinly. Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
What is missing or unclear◇Read from sources, not yet reviewed
Does the exact form matter?
Evidence belongs to the exact thing that was tested. A different salt, a different mixture or a different preparation is a different question.
The form that was studied
Intravenous infusion, 5 mg over at least 15 minutes, once yearly for osteoporosis
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The form used in the studies cited on this page.
No source is stored against this line.
What is sold
The route exists to solve the absorption problem: oral bisphosphonates deliver under 1% of a tablet, and about half of people prescribed one have stopped within a year. An infusion also cannot be undone, which is the trade in the other direction.
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
Recorded notes on which forms are sold and how they compare.
No source is stored against this line.
What is recorded as being sold
50 products list this as an active ingredient in the United States drug directory. 50 of them contain it and nothing else.
FDA National Drug Code directory · 72266-152 · read 2026-08-29
They are sold as injection, injection, solution, injection, solution, concentrate and powder, taken intravenous.
FDA National Drug Code directory · 72266-152 · read 2026-08-29
The regulator's established pharmacologic class for it is bisphosphonate [epc] and diphosphonates [cs].
FDA National Drug Code directory · 72266-152 · read 2026-08-29
35 published labels name it as an active ingredient. 35 of them describe this substance alone, which is where its own label text on this page comes from.
US prescribing information · 20cd29cc-cef5-48c4-adfe-6b3dfee0ab61 · read 2026-08-29
Those labels are classed as human prescription drug.
US prescribing information · 20cd29cc-cef5-48c4-adfe-6b3dfee0ab61 · read 2026-08-29
Zoledronic acid is intravenous at 3 DOSAGE FORMS AND STRENGTHS Zoledronic Acid Injection: 4 mg/5 mL (0.8 mg/mL) single-dose vial for dilution prior to intravenous infusion., recorded as fda label in effect 2023-10-18 in the United States.
US prescribing information · 20cd29cc-cef5-48c4-adfe-6b3dfee0ab61 · read 2026-08-30
Recorded price in US: 0.4774 USD per one millilitre, across 4 priced products whose strengths and pack forms differ, as of 2026-08-26, paid by retail pharmacies buying the product, as surveyed by the Centers for Medicare & Medicaid Services. It is not a list price, an insurance price, or what anyone pays at a counter..
Recorded source · 2026-08-26 · read 2026-08-28
Evidence carries across two names for one substance. It does not carry across a salt, a mirror form or a mixture.
What it would be like to take◇Read from sources, not yet reviewed
What you could measure
This one is decided with a clinician, so this section holds questions to ask rather than a plan to run.
Self-experiment planning is not offered for a prescription or clinician-supervised medicine. The questions below are for a clinician or pharmacist.
Questions worth asking
Which of the trials of Zoledronic Acid Anhydrous studied people like me?
What was measured, and for how long?
Was the result a laboratory value or a health outcome?
What would we watch for, and when would we stop?
Tracking can show whether something changed for you. It cannot show what caused it.
RNAWiki records evidence. It does not say whether this substance is right for you.
What is missing or unclear◇Read from sources, not yet reviewed
Claims that go past the evidence
Things said about this substance that sound reasonable, and the exact step that is missing between the evidence and the claim.
✗Goes past the evidence
That the mortality reduction after hip fracture is explained by the fractures prevented — the mediation analysis attributes 8% of it to that pathway
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That the mortality result generalises beyond the population studied, which was people within 90 days of a repaired hip fracture
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That the annual dosing interval was validated by fracture data — it was set by the twelve-month bone-turnover marker curve, and the fracture trial simply used it
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That the atrial fibrillation signal has been explained away; no mechanism has been established and the pooled randomised estimate remains above 1
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
What is missing or unclear◇Read from sources, not yet reviewed
What nobody knows yet
Open questions, each with why it is open and what would close it.
Missing populations
Which groups were under-represented in the studies has not been recorded.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing long-term data
No completed tested study window is recorded.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
No reviewed conclusion
RNAWiki has not yet published a reviewed conclusion for this use.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing interaction studies
No interaction was found in the registers checked. Not finding one is not the same as showing there is none.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Formulation uncertainty
Several salts, forms or products of Zoledronic Acid Anhydrous are recorded. Results from one form may not transfer to another.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Mechanism not reviewed
No reviewed mechanism story exists for this substance.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
What happened in people◇Read from sources, not yet reviewed
Check any of this yourself
Every line above traced back to the study it came from. This is the technical layer, and the vocabulary changes here.
Every line above can be traced to the study named beside it. Follow the link and read it.
Both co-primary endpoints met, including hip fracture
In plain words
Nearly eight thousand women were randomised to a yearly infusion or a yearly dummy infusion. Spinal fractures on x-ray fell from about eleven in a hundred to about three. Hip fractures fell from 2.5 in a hundred to 1.4.
What was measured
Hip fracture 1.4% against 2.5% at three years, HR 0.59 (95% CI 0.42 to 0.83); morphometric vertebral 3.3% against 10.9%, RR 0.30
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
HORIZON-PFT randomised 3889 patients to a single 15-minute infusion of zoledronic acid 5 mg and 3876 to placebo at baseline, 12 months and 24 months, with follow-up to 36 months; mean age 73. Morphometric vertebral fracture fell 70% (3.3% against 10.9%, relative risk 0.30, 95% CI 0.24 to 0.38) and hip fracture 41% (1.4% against 2.5%, hazard ratio 0.59, 95% CI 0.42 to 0.83). Non-vertebral, clinical and clinical vertebral fractures fell 25%, 33% and 77% respectively, all P<0.001. Change in renal function was similar between groups.
Written into the record, not signed off as a reviewed claim
Serious atrial fibrillation was significantly more common in the pivotal trial
In plain words
In the same trial, serious atrial fibrillation — an irregular heartbeat needing hospital treatment — occurred in 50 patients on the drug against 20 on placebo. This was not something anyone had gone looking for.
What was measured
Serious atrial fibrillation 50 against 20 patients in HORIZON-PFT (P<0.001); pooled randomised OR 1.40 (95% CI 1.02 to 1.93)
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
HORIZON-PFT reported serious atrial fibrillation in 50 zoledronic acid patients against 20 placebo patients, P<0.001, an unanticipated finding in a trial designed to measure fractures. The signal was pursued across the class. Sharma and colleagues pooled six randomised trials in 41,375 patients and six observational studies in 149,856 people: randomised evidence gave a significantly increased risk of serious atrial fibrillation requiring hospitalisation (OR 1.40, 95% CI 1.02 to 1.93), observational evidence gave OR 1.27 (1.16 to 1.39), and neither stroke (OR 1.07, 0.85 to 1.34) nor cardiovascular mortality (OR 0.92, 0.68 to 1.26) was increased. No mechanism has been established.
Written into the record, not signed off as a reviewed claim
Given after a hip fracture, it was associated with 28% fewer deaths
In plain words
Two thousand people who had just had a hip fracture repaired were given the infusion or a placebo. New fractures fell by a third, which was the point of the trial. Deaths from any cause fell by 28%, which was not.
What was measured
All-cause mortality 9.6% against 13.3% over a median 1.9 years, a 28% reduction, P=0.01
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
HORIZON-RFT randomised 1065 patients to yearly zoledronic acid 5 mg and 1062 to placebo, first given within 90 days of surgical repair of a low-trauma hip fracture, with all patients receiving calcium and vitamin D; median follow-up 1.9 years, mean age 74.5. New clinical fracture, the primary endpoint, occurred in 8.6% against 13.9%, a 35% reduction, P=0.001. In the safety analysis, 101 of 1054 (9.6%) died on zoledronic acid against 141 of 1057 (13.3%) on placebo, a 28% reduction in all-cause mortality, P=0.01. No cases of osteonecrosis of the jaw were reported and rates of atrial fibrillation and stroke were similar between groups in this trial.
Written into the record, not signed off as a reviewed claim
The survival benefit is real and almost none of it comes from preventing fractures
In plain words
The obvious explanation for fewer deaths is fewer fractures. When the trialists tested that explanation formally, preventing fractures accounted for only 8% of the survival difference. The rest is unexplained.
What was measured
That the mortality reduction is explained by the fractures prevented — the formal mediation analysis attributes 8% of it to that pathway and leaves the remainder unaccounted for
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Colón-Emeric and colleagues analysed 2111 HORIZON-RFT participants with causes of death adjudicated by a blinded central committee. Adjusted for baseline risk factors, zoledronic acid reduced death by 25% (95% CI 0.58 to 0.97). Subsequent fracture was strongly associated with death (hazard ratio 1.72, 95% CI 1.17 to 2.51) but explained only 8% of the treatment effect. Adjusting for acute events during follow-up eliminated the death benefit, and treated patients were less likely to die of pneumonia (interaction P=0.04) and of arrhythmia (interaction P=0.02). The authors describe the analysis as exploratory and suggest studies of zoledronic acid in other acute illnesses. This is an unexplained finding presented as one, not a mechanism.
Written into the record, not signed off as a reviewed claim
The class failed in osteopenia orally, then succeeded in osteopenia intravenously
In plain words
Oral bisphosphonates were never shown to prevent fractures in women whose bones were only mildly thin. A six-year New Zealand trial gave the intravenous drug to two thousand such women and found fractures fell by more than a third.
What was measured
That bisphosphonates do not work in osteopenia — an inference from short, small oral trials that a six-year intravenous trial in 2000 women overturned
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Reid and colleagues randomised 2000 women aged 65 or over with osteopenia — a T-score of -1.0 to -2.5 at the total hip or femoral neck — to four infusions of zoledronate 5 mg or saline at 18-month intervals over six years. Median baseline 10-year hip-fracture risk was 2.3%. A fragility fracture, the primary endpoint, occurred in 122 of the zoledronate group against 190 of the placebo group, hazard ratio 0.63 (95% CI 0.50 to 0.79, P<0.001), number needed to treat 15. Non-vertebral fragility fracture hazard ratio was 0.66 (P=0.001), symptomatic fracture 0.73 (P=0.003) and vertebral fracture odds ratio 0.45 (P=0.002). The contrast with the oral primary-prevention literature is not a contradiction about the class: it is a trial that was adequately sized and long enough where the oral ones were not.
Written into the record, not signed off as a reviewed claim
The commonest adverse reactions are not rare and are not minor
In plain words
More than one in ten people get fever, muscle pain, headache, joint pain or pain in a limb after an infusion. It usually passes in a day or two and is much less likely after the second one, but it is the usual reason people decline the second.
What was measured
Not recorded
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
The Reclast label lists pyrexia, myalgia, headache, arthralgia and pain in extremity each above 10%, with flu-like illness, nausea, vomiting, diarrhoea and eye inflammation as other important reactions. Separate labelled warnings cover hypocalcaemia worsening during treatment, renal toxicity requiring a dose cap of 5 mg and an infusion of at least 15 minutes with creatinine clearance measured before each dose, osteonecrosis of the jaw, atypical femoral fracture and severe bone, joint or muscle pain for which future doses are to be withheld. The label also warns that patients receiving Zometa must not receive Reclast, the two being the same molecule at different doses.
Source
Reclast (zoledronic acid injection) United States prescribing information, Warnings and Precautions 5.1 to 5.6 and Adverse Reactions 6 (openFDA label endpoint)
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
caution
Review state
Written into the record, not signed off as a reviewed claim
How many documents were read
35 documents were read for this substance.
RNAWiki source record
35 of them state the same halfLife, and they agree.
RNAWiki source record
Where else this substance is registered
FDA substance identifier (UNII)
6XC1PAD3KF
RxNorm concept
351114
Checks this page had to pass
✓ Passed
Identity resolved
no open identity hold
✓ Passed
No unresolved merge across substance families
no quarantine open
✓ Passed
Every public sentence names a source
The opening statement carries the origin: Written into the record, not signed off.
✗ Not passed
Trial roles classified for highlighted evidence
No registered study is classified as testing this substance.
✓ Passed
No internal keys in reader text
enforced by the copy-contract test over the rendered page
✓ Passed
Safety mode resolved
Suppression classes recorded: S3.
✓ Passed
Canonical metadata present
slug and display name present
What is missing or unclear◇Read from sources, not yet reviewed
How this medicine reached us
Kept near the foot of the page. A historical event moves up only when it changes something about this substance today.
What the approval register records
54 approved applications cover products containing this substance. The earliest was NDA021223, approved 20010820 to NOVARTIS.
This order is fixed in code and does not count clicks or time on the page.
What is not here
3 questions this page could not answer
These sections were prepared and left out because there was nothing to put in them. They are listed rather than hidden, so the gaps in this record are visible.
What it may clash with — found nothing in the sources checked.
Other ways to the same goal — found nothing in the sources checked.
What changed on this page — found nothing in the sources checked.
The record as stored
The full record, for auditing
Everything above is built from what is below. This layer keeps the technical vocabulary, record identifiers and every stored row, so a reader who wants to check the page can.
The older medicine-wide conclusion held in this record
Written for a clinical reader, and about the medicine as a whole rather than about one indication, population and set of trials. RNAWiki does not treat it as a programme conclusion and no reviewer has signed it off in that form. It is here word for word because it is what the record holds.
A once-yearly infusion of the most potent bisphosphonate that cut morphometric vertebral fractures from 10.9% to 3.3% and hip fractures from 2.5% to 1.4% in 7765 women over three years, and, given after a hip fracture in 2127 patients, was associated with 28% fewer deaths from any cause that a mediation analysis could only trace 8% of to the fractures it prevented — while serious atrial fibrillation occurred in 50 patients against 20 on placebo.
Recorded evidence blocks (13)
Q2
What did Zoledronic Acid Anhydrous's largest trial (18028 people) and its longest (32 years) measure?
18028 people in Zoledronic Acid Anhydrous's largest registered study, 32 years in its longest registered window, measuring Prostate cancer-specific mortality. ClinicalTrials.gov · 2026-09-01
108 phase3, 84 phase2, 82 phase4, 31 phase1, 22 na, 15 na or unstated; NCT04725422; 2050-08. Last human test completed 2026, NCT05025293.
Interpretation These counts include studies where Zoledronic Acid Anhydrous was a comparison treatment, a background treatment or an exposure in an observational study, and the longest window may be a planned end date. Trial roles have not yet been classified for this record.
Show the evidence
phase3
108
phase2
84
phase4
82
phase1
31
na
22
na or unstated
15
1 more recorded row
Last recorded human testNCT05025293
2026-06-11
recorded 2026-09-01 · last checked 2026-09-04
Q3
From C. elegans to human: where has Zoledronic Acid Anhydrous shown lifespan?
"Closed by the research committee"; 38 of 322 registered studies
Show the evidence
Trial
NCT00058188
terminated; "Closed by the research committee"
NCT00130494
terminated; "Low recruitment"
NCT00171925
terminated; "Recruitment in study could not be reached after 8 yrs of recruiting"
NCT00215943
terminated; "Poor accrual, changes in management of newly diagnosed myeloma patients, new drugs/more effective regimens."
NCT00216151
terminated; "Study terminated due to low patient enrollment."
NCT00258258
terminated; "Withdrawn due to low accrual"
14 further recorded trials
NCT00258765
terminated; "Poor recruitment \& not feasible to continue"
NCT00265200
terminated; "funding discontinued by sponsor"
NCT00278434
terminated; "Accrual was insufficient to meet study endpoints"
NCT00294437
terminated; "underfunding"
NCT00301886
withdrawn; "withdrawn support for study"
NCT00333229
terminated; "Due to rare patient population, planned number of patients could not be recruited in a reasonable timeframe. Recruitment was stopped prematurely."
NCT00458796
terminated; "Lower than expected recruitment"
NCT00582790
terminated; "slow accrual"
NCT00639392
withdrawn; "Ended early due to inability to identify eligible subjects"
NCT00844480
terminated; "difficulty in enrollment"
NCT00873808
withdrawn; "lack of accrual"
NCT00889590
terminated; "low recruitment with registration denosumab"
NCT00892242
terminated; "Principal Investigator decided to close the study early."
NCT00966992
terminated; "Lack of enrollment"
recorded 2026-09-01 · last checked 2026-09-04
Q5
Human studies of Zoledronic Acid Anhydrous used Zoledronic acid 4 mg — over how long?
infusion; Zoledronic acid 5mg/100ml solution for infusion
humanNCT04279392
Zoledronic Acid 5 mg/Bag 100 ml Inj
humanNCT04779216
Zoledronic acid 5 mg
humanNCT05164952
Zoledronic Acid 4 MG
humanNCT05614778
injection; Zoledronic Acid injection, 5mg/100mL
humanNCT06118905
Zoledronic Acid 5Mg/Bag 100Ml Infusion
recorded 2026-09-01 · last checked 2026-09-04
Q6
Zoledronic Acid Anhydrous's half-life is 146 hours — which schedules were studied?
146 hours, the half-life Zoledronic Acid Anhydrous's label states. openfda-label · 8aac81ae-f92c-4f0b-b480-44badf72b5f5 · 2026-08-30
Show the evidence
half life
146 hours hours; The terminal elimination phase of zoledronic acid was prolonged, with very low concentrations in plasma between Days 2 and 28 postinfusion, and a terminal elimination half-life t 1/2γ of 146 hours.
metabolism
In vitro mean zoledronic acid protein binding in human plasma ranged from 28% at 200 ng/mL to 53% at 50 ng/mL. Metabolism Zoledronic acid does not inhibit human P450 enzymes in vitro .
recorded 2026-08-30 · last checked 2026-09-04
Q7
Which of best response, bone density and bone mineral density did Zoledronic Acid Anhydrous's trials measure?
best response, bone density and bone mineral density lead 40 outcome terms across Zoledronic Acid Anhydrous's trials. ClinicalTrials.gov · 2026-09-01
Interpretation time to first skeletal related event, progression free survival, best response, disease progression, bone density and disease free survival follow.
Show the evidence
bone mineral density in the lumbar spine
1
confirmed response
1
lumbar spine bone mineral density
1
time to first skeletal related event
1
progression free survival
1
best response
1
14 more recorded rows
disease progression
1
bone density
1
disease free survival
1
lumbar spine bmd after 12 months of letrozole therapy
1
days of progression free survival
1
pain reduction
1
prostate cancer specific mortality
1
toxicity
1
maximum tolerated dose
1
response rates of vad vs thalidomide/dexamethasone
1
pet ct
1
overall survival
1
time to first on study skeletal related event
1
time to the first on study sre
1
recorded 2026-09-01 · last checked 2026-09-04
Q8
Which of Zoledronic Acid Anhydrous's 27 ongoing trials reports first?
"Systemic Therapy in Advancing or Metastatic Prostate Cancer: Evaluation of Drug Efficacy"; n 11992; "Overall survival"; 2030-12
NCT00470223
"Combined Chemotherapy With or Without Zoledronic Acid for Patients With Osteosarcoma"; n 318; "Event-free survival"; 2026-12
NCT02508038
"Alpha/Beta CD19+ Depleted Haploidentical Transplantation + Zometa for Pediatric Hematologic Malignancies and Solid Tumors"; n 22; "Incidence of acute graft versus host disease (GVHD)"; 2027-12
NCT03073785
"Hypofractionated Stereotactic Body Radiation & Fluorouracil or Capecitabine for Locally Advanced Pancreatic Cancer"; n 46; "Local control With and Without Zometa at Four Months in Follow-up"; 2027-12
NCT03173976
"Anti-Osteoclast Therapy as Neoadjuvant in Treatment of Chondrosarcoma - Phase 1b Trial"; n 17; "Phase 1b cohort: Dose Limiting Toxicity - to examine the toxicity related to the therapy by measuring the number of treatment related adverse events in patients"; 2028-05-01
NCT03295981
"Local Bisphosphonate Effect on Recurrence Rate in Extremity Giant Cell Tumor of Bone"; n 120; "The endpoint for patient participation will be local recurrence"; 2028-01
14 further recorded trials
NCT04488614
"Prospective Breast Cancer Biobanking"; n 1200; "Relapse Free Survival"; 2030-07-15
NCT04549207
"Comparing Continuation or De-escalation of Bone Modifying Agents (BMA) in Patients Treated for Over 2 Years for Bone Metastases From Either Breast or Castration-resistant Prostate Cancer"; n 240; "Health related quality of life scores"; 2026-09
NCT04608630
"Bone Loss Prevention With Zoledronic Acid or Denosumab in Critically Ill Adults"; n 450; "Annualised change in femoral neck bone mineral density for the year after Intensive Care discharge"; 2027-02-28
NCT04725422
"CHronic Nonbacterial Osteomyelitis International Registry"; n 2000; "The change of CNO disease activity score"; 2050-08
NCT05058976
"Romosozumab Use to Build Skeletal Integrity"; n 184; "Bone Mineral Density of the total hip"; 2027-03-31
NCT05655013
"Treatment With Zoledronate Subsequent to Denosumab in Osteoporosis 2 (ZOLARMAB2)"; n 200; "Change in lumbar spine bone mineral density (BMD)"; 2027-02-01
NCT05666310
"Muscle Impact of Treating Osteoporosis"; n 20; "Percentage change from baseline in muscle mass (kg) measured by D3-Creatine"; 2026-09-05
NCT05906056
"Continuous Passive Motion Versus Heterotopic Ossification"; n 20; "ROM lost during the trial"; 2027-03-25
NCT06059222
"The Optimised Use of Romozosumab Study"; n 270; "Change in total hip BMD"; 2032-08-31
NCT06118905
"Preserving Geriatric Muscle With an Osteoporosis Medication"; n 155; "Knee extension strength change"; 2029-03-31
NCT06164795
"Sequential Therapies After Osteoanabolic Treatment"; n 150; "lumbar spine bone mineral density"; 2027-12
NCT06221072
"A Study to Assess the Prevention of Bone-related Events in Patients With Bone Metastases From Malignant Solid Tumors Treated With JMT103 Compared to Zoledronic Acid"; n 1360; "Time to the First on-study Skeletal-Related Event (SRE)"; 2028-05-31
NCT06374459
"Zunsemetinib in Combination With Capecitabine in Patients With Hormone Receptor-Positive and HER2-Negative Metastatic Breast Cancer With Bone Metastasis"; n 152; "Number of participants with adverse events (Phase Ib only)"; 2032-05-31
NCT06533865
"Romosozumab as an Adjunct to Physiologic Estrogen Replacement in Functional Hypothalamic Amenorrhea"; n 114; "Lumbar spine bone density"; 2029-04
recorded 2026-09-01 · last checked 2026-09-04
Q9
Which running trial of Zoledronic Acid Anhydrous could settle lifespan?
NCT00470223 measures Event-free survival, reading out 2026-12.
4 open trials; n 318; "Combined Chemotherapy With or Without Zoledronic Acid for Patients With Osteosarcoma"
Show the evidence
Trial
NCT00470223
"Combined Chemotherapy With or Without Zoledronic Acid for Patients With Osteosarcoma"; n 318; "Event-free survival"; 2026-12
NCT06625190
"Alpha/Beta T and B Cell Depletion With Zoledronic Acid for Solid Tumors"; n 27; "Disease-free survival rate"; 2030-02
NCT04488614
"Prospective Breast Cancer Biobanking"; n 1200; "Relapse Free Survival"; 2030-07-15
NCT00268476
"Systemic Therapy in Advancing or Metastatic Prostate Cancer: Evaluation of Drug Efficacy"; n 11992; "Overall survival"; 2030-12
Q10
Which 98 trials of Zoledronic Acid Anhydrous posted no result?
Posted no result
98 of 98 completed trials
Registrations
NCT00003884, NCT00029224, NCT00035997, NCT00114556, NCT00004928 and NCT00063609, and 92 more
Completion dates
oldest 2001-01; newest 2024-08-12
Show the evidence
Trial
NCT00003884
2001-01
NCT00029224
2002-11
NCT00035997
2004-01
NCT00114556
2004-08
NCT00004928
2004-10
NCT00063609
2005-04
14 further recorded trials
NCT00100555
2005-06
NCT00520052
2005-08
NCT00145275
2005-10
NCT00097812
2005-12
NCT00033332
2006-06
NCT00126386
2006-09
NCT00219219
2006-10
NCT00181558
2006-12
NCT00046254
2007-02
NCT00171639
2007-03
NCT00264420
2007-03
NCT00100620
2007-04
NCT00063479
2007-05
NCT00087659
2007-05
Q11
At the median, Zoledronic Acid Anhydrous's trials enrolled 69 people — anything larger?
Median enrolment
69
Largest enrolment
18028
Registered trials counted
315
Q12
What do 22089 spontaneous reports say about Zoledronic Acid Anhydrous — and not say?
These are reports people sent to a regulator. They do not show the medicine caused the reaction. Nobody counted how many people took the medicine and reported nothing. The same event can be reported more than once, and many reports are incomplete. News coverage, lawsuits and new warnings change how often people report. A count is not a rate and not a risk.
Zoledronic Acid Anhydrous appears in spontaneous reports to regulators. Across the 10 most-reported reaction terms, 22089 reaction mentions were counted: osteonecrosis of jaw 5228; osteonecrosis 4264; pain 2309; pyrexia 2049. open-targets-adr · CHEMBL4303669 · 2026-06-24
Show the evidence
osteonecrosis of jaw
5228
osteonecrosis
4264
pain
2309
pyrexia
2049
arthralgia
1765
bone disorder
1515
4 more recorded rows
pain in jaw
1345
tooth extraction
1301
myalgia
1161
osteomyelitis
1152
recorded 2026-06-24 · last checked 2026-09-04
Q13
Was Zoledronic Acid Anhydrous studied with fasting?
fasting is named in Zoledronic Acid Anhydrous's label sentences: "We tested whether antiresorptive therapies result in higher fasting glucose, increased weight, or greater diabetes incidence in post hoc analyses of three randomized, placebo-controlled trials in postmenopausal women: Fracture Intervention Trial (FIT) (N = 6151) of alendronate (4 years), Health…" openfda-label+europepmc · 2013-06-01
1 recorded statement; fasting
Show the evidence
fasting
We tested whether antiresorptive therapies result in higher fasting glucose, increased weight, or greater diabetes incidence in post hoc analyses of three randomized, placebo-controlled trials in postmenopausal women: Fracture Intervention Trial (FIT) (N = 6151) of alendronate (4 years), Health Outcomes and Reduced Incidence with Zoledronic Acid Once Yearly Pivotal Fracture Trial (HORIZON-PFT) (N…
recorded 2013-06-01 · last checked 2026-09-04
Q14
What is recorded about Zoledronic Acid Anhydrous and autophagy?
"At the non-apoptotic doses, zoledronic acid (ZOL) inhibited autophagy by blocking autophagic flux and delaying the degradation of autophagy-related proteins." — where Zoledronic Acid Anhydrous and autophagy appear together. Europe PMC · pathway abstract search · 2026-06-28
"At the non-apoptotic doses, zoledronic acid (ZOL) inhibited autophagy by blocking autophagic flux and delaying the degradation of autophagy-related proteins."
PMID 42316434
"These findings provide insights into how BPs disrupt osteoclast function by blocking autophagy and suggest that targeting autophagy in osteoclasts could be a potential therapeutic approach for bone-related diseases.<b>Abbreviations</b>: ACP5/TRAP: acid phosphatase 5, tartrate resistant, ATG: autophagy related, 54 BafA1: bafilomycin A1, BECN1: beclin 1, BMM: bone marrow-derived macrophage, CQ: 55…"
senolytic
PMID 37154858
"Because senescent cells accumulate with aging and contribute to multiple co-morbidities, the non-skeletal actions of zoledronic acid could be due to senolytic (killing of senescent cells) or senomorphic (inhibition of the secretion of the senescence-associated secretory phenotype [SASP]) actions."
PMID 37154858
"To establish that these cells are potential senolytic/senomorphic targets of zoledronic acid, we used single cell proteomic analysis (cytometry by time of flight [CyTOF]) and demonstrated that zoledronic acid significantly reduced the number of pre-osteoclastic (CD115+/CD3e-/Ly6G-/CD45R-) cells and decreased protein levels of p16, p21, and SASP markers in these cells without affecting other…"
PMID 37154858
"Collectively, our findings demonstrate that zoledronic acid has senolytic effects <i>in vitro</i> and modulates senescence/SASP biomarkers <i>in vivo</i>."
mTORPMID 40979744
"Preclinical studies highlight EVR's synergistic potential with targeted agents (e.g., sorafenib, zoledronic acid), chemotherapy (e.g., doxorubicin), and proteasome inhibitors (e.g., bortezomib), achieving >50% tumor volume reduction and metastasis suppression in xenograft models through dual mTORC1/2 blockade, stress-apoptosis activation, and microenvironment remodeling."
autophagyPMID 37477258
"Furthermore, the level of autophagy and apoptosis in zoledronic acid (ZA)-treated human keratinocytes cell lines (HaCaT cells) was concentration dependent <i>in vitro</i>."
sirtuinPMID 29263373
"Here, we have investigated the combination between miR-34a and γ-secretase inhibitor (γSI), Sirtinol or zoledronic acid (ZOL) in order to enhance the inhibitory action of this miRNA on its canonical targets such as Notch1 and SIRT1, and on Ras/MAPK-dependent pathways."
mTOR
PMID 26886375
"We report an 18-year-old male with Gorham-Stout disease manifested by lytic rib lesions and an intractable pleural effusion that responded dramatically to the combination of the mammalian target of rapamycin (mTOR) inhibitor sirolimus and the aminobisphosphonate zoledronic acid after failing interferon therapy."
PMID 24023313
"Western blot analysis showed that the inhibitory effect of zoledronic acid on growth was related to the extent of inhibition of phosphorylated-protein kinase B (p-AKT), and phosphorylated-mammalian target of rapamycin (p-mTOR)."
recorded 2026-06-28 · last checked 2026-09-04
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