Evidence for hip fracture risk reduction is also limited. Strontium ranelate was the only drug to demonstrate hip fracture reduction in older patients with confirmed osteoporosis. In the zoledronic acid study, although patients under 75 years showed a significant hip fracture risk reduction, it did not translate into statistically significant benefits for those over 75 years. However, this study was limited by its power to demonstrate a benefit. The trials that evaluated risedronate and
clodronate in older patients with hip fractures demonstrated no benefit. However, these studies targeted old, frail patients with risk factors rather than established osteoporosis. This is at odds with the demonstrated benefit in the HIP cohort (under 80 years) and the intention–to–treat cohort (70 to 100 years).