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Long term bisphosphonate use in osteoporotic patients; a step forward, two steps back
Pooneh Salari1, Mohammad Abdollahi
1Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. poonehsalari@gmail.com
Summary
Bisphosphonates effectively reduce vertebral fractures short-term but long-term use carries risks like jaw osteonecrosis and esophageal cancer. Careful risk-benefit assessment is crucial for osteoporosis treatment.
Area of Science:
- Pharmacology
- Orthopedics
- Oncology
Background:
- Bisphosphonates are primary treatments for osteoporosis.
- Long-term bisphosphonate therapy may pose significant health risks.
Purpose of the Study:
- To review serious adverse effects of bisphosphonates.
- To assess the risk-benefit profile of bisphosphonate therapy.
Main Methods:
- Systematic review of relevant literature.
- Searched PubMed, Web of Science, Scopus for bisphosphonates and adverse effects.
- Included studies on fracture risk, atrial fibrillation, osteonecrosis of the jaw, and esophageal cancer.
Main Results:
- Short-term bisphosphonate use reduces vertebral fractures.
- Long-term use is linked to osteonecrosis of the jaw, esophageal cancer, atrial fibrillation, and increased atypical fracture risk.
- No consensus exists on safe long-term bisphosphonate duration or effects.
Conclusions:
- Clinicians must exercise caution with bisphosphonates.
- A thorough risk-benefit analysis and treatment duration assessment are essential.
- Further research on long-term side effects and alternative osteoporosis treatments is needed.
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