Zoledronate, fractures, and mortality after hip fracture [1]

To the Editor:
The increased use of composite end points in clinical studies makes it harder for clinicians to translate the findings into treatment decisions. The Health Outcomes and Reduced Incidence with Zoledronic Acid Once Yearly (HORIZON) Recurrent Fracture Trial, reported by Lyles et al. (Nov. 1 issue) is no exception.
In this study, the primary end point was new clinical fractures, which included burdensome but relatively less severe fractures, such as vertebral fractures, and potentially life-threatening hip fractures.