Duration of Bisphosphonate Treatment.
10.3904/kjm.2014.87.2.151
- Author:
Kyoung Min KIM
1
;
Yumie RHEE
Author Information
1. Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea.
- Publication Type:Review
- Keywords:
Bisphosphonates;
Osteoporosis;
Safety;
Drug holiday
- MeSH:
Bone Density;
Diphosphonates;
Holidays;
Humans;
Jaw;
Metabolism;
Osteonecrosis;
Osteoporosis;
Risk Factors
- From:Korean Journal of Medicine
2014;87(2):151-155
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Large, randomized, controlled trials have demonstrated the efficacy of bisphosphonates (BP) in terms of improving bone mineral density (BMD) and reducing fracture risk. Consequently, bisphosphonates are used widely in the treatment of osteoporosis. Recently, however, several safety issues regarding the long-term use of BP, especially BP-related osteonecrosis of the jaws and atypical fractures, have been noted and have emerged as a limitation of their clinical use. Although the absolute risk is very small, the risks could increase with the long-term use of BP. The anti-fracture efficacy of BP is not sustained after treatment for 5-10 years. Therefore, recommendations suggest that a drug holiday be considered after 5 years of treatment for patients at low risk of fracture. However, as the individual fracture risk varies, the treatment duration should be based on individual clinical risk factors and bone metabolism status. Moreover, recommendations regarding monitoring after discontinuing and reinitiating BP await further studies.
