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Adverse effects of bisphosphonates.

Bo Abrahamsen¹

¹Department of Internal Medicine and Endocrinology F, Copenhagen University Hospital Gentofte, Niels Andersensvej 65, Hellerup, Denmark. b.abrahamsen@physician.dk

Calcified Tissue International

|April 22, 2010

Summary

Bisphosphonates are widely used for osteoporosis, with common side effects including gastrointestinal issues. Serious adverse events like jaw osteonecrosis and atypical fractures are rare, but reassessment of bone density and risk is advised.

Area of Science:

Pharmacology
Bone Metabolism
Patient Safety

Background:

Bisphosphonate use has increased due to simpler dosing, generics, and hormone therapy concerns.
While generally safe, bisphosphonates can cause serious adverse events in some patients.
Clinical trials often lack power to detect rare adverse effects.

Purpose of the Study:

To review adverse events associated with bisphosphonate therapy.
To assess the incidence and nature of bisphosphonate-related adverse events.
To inform clinical practice regarding long-term bisphosphonate use.

Main Methods:

Systematic review of published literature.
Inclusion of data from case reports, databases, surveys, and clinical trials.

Related Experiment Videos

Analysis of adverse event reporting databases.

Main Results:

Common acute adverse events include gastrointestinal discomfort and influenza-like illness.
Renal complications are rare with appropriate oral and IV bisphosphonate use.
Osteonecrosis of the jaw and atypical fractures are rare compared to osteoporotic fracture risk.

Conclusions:

Bisphosphonates have a generally favorable safety profile for osteoporosis treatment.
The causality of atypical fractures with bisphosphonates requires further high-quality studies.
Physicians should reassess bone mineral density and risk factors after 3-5 years to optimize treatment duration.