Journal Club E63: The One-Bag Fix: Zoledronic Acid After the Fracture That Almost Wasn't Treated

HORIZON proved that annual intravenous zoledronic acid after a hip fracture reduces new clinical fractures and all-cause mortality. What it did not test is timing. No randomized trial has ever compared in-hospital dosing against delayed outpatient dosing, but a 2024 target trial emulation and the 2023 Five Nations Consensus both support giving the infusion before discharge - because for most of these patients the hospitalization is the only treatment opportunity anyone gets.