Bisphosphonate therapy for osteoporosis: Benefits, risks, and drug holiday
Journal article
McClung, Michael R., Harris, Steven T., Miller, Paul D., Bauer, Doug C., Davison, K. Shawn, Dian, Larry, Hanley, David A., Kendler, David L., Yuen, Chui Kin and Lewiecki, E. Michael. (2013). Bisphosphonate therapy for osteoporosis: Benefits, risks, and drug holiday. American Journal of Medicine. 126(1), pp. 13 - 20. https://doi.org/10.1016/j.amjmed.2012.06.023
Authors | McClung, Michael R., Harris, Steven T., Miller, Paul D., Bauer, Doug C., Davison, K. Shawn, Dian, Larry, Hanley, David A., Kendler, David L., Yuen, Chui Kin and Lewiecki, E. Michael |
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Abstract | The amino-bisphosphonates are first-line therapy for the treatment of most patients with osteoporosis, with proven efficacy to reduce fracture risk at the spine, hip, and other nonvertebral skeletal sites. Further, bisphosphonates have been associated with a significant decrease in morbidity and increase in survival. Following the use of bisphosphonates in millions of patients in clinical practice, some unexpected possible adverse effects have been reported, including osteonecrosis of the jaw, atypical femur fractures, atrial fibrillation, and esophageal cancer. Because bisphosphonates are incorporated into the skeleton and continue to exert an antiresorptive effect for a period of time after dosing is discontinued, the concept of a drug holiday has emerged, whereby the risk of adverse effects might be decreased while the patient still benefits from antifracture efficacy. Patients receiving bisphosphonates who are not at high risk for fracture are potential candidates for a drug holiday, while for those with bone mineral density in the osteoporosis range or previous history of fragility fracture, the benefits of continuing therapy probably far outweigh the risk of harm. |
Keywords | adverse events; bisphosphonates; drug holiday; fracture |
Year | 2013 |
Journal | American Journal of Medicine |
Journal citation | 126 (1), pp. 13 - 20 |
Publisher | Excerpta Medica, Inc. |
ISSN | 0002-9343 |
Digital Object Identifier (DOI) | https://doi.org/10.1016/j.amjmed.2012.06.023 |
Page range | 13 - 20 |
Research Group | Institute for Health and Ageing |
Publisher's version | File Access Level Controlled |
Place of publication | United States of America |
https://acuresearchbank.acu.edu.au/item/89w8v/bisphosphonate-therapy-for-osteoporosis-benefits-risks-and-drug-holiday
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