Benefits of Continuing Bisphosphonate Therapy in High Risk Osteoporosis Patients

by Dr. Trupti Shirole on  January 5, 2016 at 7:35 PM Research News
RSS Email Print This Page Comment bookmark
Font : A-A+

Bisphosphonates are a family of drugs used to treat osteoporosis. They bind to the surface of bone and slow down bone-eroding cells (osteoclasts). The therapies effectively reduce the risk of hip, vertebral and other fractures in patients with osteoporosis. Because bisphosphonates reside in bone even after the patient stops taking the medication, they have a persistent, although gradually waning, effect on bone.
 Benefits of Continuing Bisphosphonate Therapy in High Risk Osteoporosis Patients
Benefits of Continuing Bisphosphonate Therapy in High Risk Osteoporosis Patients

A new editorial published by an International Osteoporosis Foundation (IOF) Working Group urges physicians to individualize treatment decisions based on their patients' fracture risk, rather than automatically interrupting or stopping bisphosphonate therapy after five or three years.

The concept of a bisphosphonate 'holiday' arose following concerns about osteonecrosis of the jaw (ONJ) and atypical femoral fracture (AFF), rare events which have recently been linked to long-term use of bisphosphonates.

Some physicians are automatically stopping bisphosphonates in patients without consideration of the patient's high risk of fracture. Some physicians mistakenly extend the holiday concept to other antiresorptive drugs, where bone density gains are quickly lost when the drugs are discontinued.

The concept of a need for a drug holiday fuels concerns in patients about rare side effects and makes them unnecessarily fearful of anti-osteoporosis drugs. Adherence to osteoporosis drug treatment is uniformly low and the above-mentioned concerns are leading to even lower uptake of medication - with greater numbers of high-risk patients left unprotected against fractures.

"There is much clinical confusion about best practice. We have little global consensus on how to identify which patients should have a drug holiday, and how to manage and monitor these patients. More research is needed so that we can provide physicians with clear recommendations. In the meantime we want to remind physicians and patients alike that while the incidence of AFF and ONJ are very rare, hip and spinal fractures in high risk patients are, in contrast, far more common and a major cause of disability, loss of quality of life and early death. The benefits of bisphosphonate therapy with regard to reduced fracture incidence in moderate and high risk women clearly outweigh the risk of rare adverse events," said lead author Professor Stuart Silverman, Cedars-Sinai Medical Center and Professor of Medicine, University of California, Los Angeles (UCLA).

The authors suggest that clinicians need to rethink the assumption that a patient who has taken an oral bisphosphonate for five years or an intravenous therapy for three years should automatically start a drug holiday. Instead the clinician should individualize the decision for each patient based on their fracture risk.

Source: Eurekalert

Post a Comment

Comments should be on the topic and should not be abusive. The editorial team reserves the right to review and moderate the comments posted on the site.
Notify me when reply is posted
I agree to the terms and conditions

Recommended Reading

More News on:

Fracture Rickets Osteoporosis Lifestyle And Osteoporosis Kyphosis Reiki and Pranic Healing Colle’s Fracture Fracture Neck of Femur Back Pain at Workplace: Prevention and Exercises Screening for Osteoporosis 

News A - Z


News Search

Medindia Newsletters

Subscribe to our Free Newsletters!

Terms & Conditions and Privacy Policy.

Find a Doctor

Stay Connected

  • Available on the Android Market
  • Available on the App Store

News Category

News Archive