[Treatment with bisphosphonates: daily or once-weekly oral administration and intravenous injection]

Oral bisphosphonates are among the most effective therapeutics available to manage osteoporosis, which increase bone mineral density and reduce the incidence of fractures. Although daily administration of bisphosphonates has been well tolerated in most clinical use, some patients develop upper gastrointestinal symptoms. Once-weekly bisphosphonates offers convenience to patients while showing equal efficacy, which may also provide improved compliance and a lower risk of gastrointestinal symptoms. Now, both alendronate and risedronate are available in once-weekly formulations in US and European countries, which have efficacy and tolerability possibly better than the once-daily doses. Under certain circumstances, intermittent treatment with injectable bisphosphonates could be an alternative when compliance is at risk. This type of treatment must be applicable to some Japanese osteoporotic patients in the nearest future.