[Bisphosphonates]

After the development of potent bisphosphonates including alendronate and risedronate, evidence has accumulated that not only vertebral but also non-vertebral fractures can be prevented by these agents. In addition, numbers needed to treat for both vertebral and non-vertebral fractures by alendronate and risedronate are around 30 to 90. Thus, these agents are expected to improve the socio-economical situation of osteoporosis treatment as well as the survival and quality of life of osteoporotic patients. Once-a-week oral bisphosphonates and long-acting intravenous formula that can successfully inhibit bone resorption for 3 months or longer are also under development. Although PTH and alendronate treatment in combination did not show much beneficial effects, there are results showing additive effect of sequential treatment with PTH followed by alendronate. From these studies, we can expect even better prospect for osteoporosis treatment by choosing from or sequentially combining these different modality of therapies.