Anastasilakis AD, et al. - Women were randomized to receive a single 5-mg infusion of zoledronate (ZOL) (n = 27) or two additional 60-mg injections of denosumab (Dmab) (n = 30) in order to examine the efficiency of zoledronate to halt the bone loss in women with postmenopausal osteoporosis who were treated with denosumab and discontinued treatment following attaining osteopenia. Results of the femoral neck (FN)-BMD changes were comparable. ZOL infusion was followed by small yet notable raises in serum procollagen type 1 N-terminal propeptide (P1NP) and C-terminal telopeptide of type 1 collagen (CTX) during the first year and stabilization consequently. In the Dmab group, during the first 12 months, bone turnover marker values did not vary, however, it rose significantly at 15 months and in the majority of women, these continued to be raised at 24 months. Neither baseline nor 12-month bone turnover marker values were related to BMD variations in either group of women. In the Dmab group, three individuals maintained vertebral fractures (two individuals multiple clinical, one individual morphometric) whereas one in the ZOL group maintained clinical vertebral fractures 12 months following the infusion. In summary, irrespective of the rate of bone turnover, a single intravenous infusion of ZOL given 6 months following the last Dmab injection inhibits bone loss for at least 2 years. Moreover, follow-up is suggested, since in a few cases ZOL treatment may not have the anticipated influence at 2 years.