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Related Experiment Videos

Risks and benefits of long-term bisphosphonate therapy.

Ginelle A Schmidt1, Kathleen E Horner, Deanna L McDanel

  • 1Drake University, Des Moines, IA, USA.

American Journal of Health-System Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
|June 3, 2010
PubMed
Summary

Long-term bisphosphonate therapy effectively prevents fractures for 7-10 years. For lower-risk patients, a drug holiday may be considered after 2-5 years to mitigate potential risks.

Related Experiment Videos

Area of Science:

  • Pharmacology
  • Bone Metabolism
  • Osteoporosis Treatment

Background:

  • Bisphosphonates are a first-line treatment for osteoporosis, reducing fracture risk.
  • Benefits on bone mineral density (BMD) and fracture prevention are sustained for 7-10 years.
  • Concerns exist regarding long-term bisphosphonate use, including potential increased risk of fragility fractures due to bone turnover oversuppression.

Purpose of the Study:

  • To review the risks and benefits of long-term bisphosphonate therapy.
  • To evaluate the optimal duration of bisphosphonate treatment for osteoporosis.
  • To consider the role of drug holidays in managing long-term bisphosphonate therapy.

Main Methods:

  • Review of existing clinical trials and reports on bisphosphonate therapy.
  • Analysis of data on fracture risk, BMD changes, and adverse events.
  • Evaluation of residual therapeutic effects and fracture benefits after drug discontinuation.

Main Results:

  • Bisphosphonates demonstrate sustained fracture risk reduction for 7-10 years.
  • Rare fragility fractures may occur after 3-8 years of therapy.
  • Residual fracture benefit is observed for 2-5 years post-discontinuation in select patients.

Conclusions:

  • Long-term bisphosphonate therapy benefits likely outweigh risks in high-risk patients.
  • For lower-risk patients, discontinuing therapy for 2-5 years may be considered.
  • Drug holidays can be a strategy to mitigate potential long-term risks while maintaining fracture protection.