Bisphosphonate Drug Holiday? Celebrate?

Excerpt

Bisphosphonates are the mainstay of treatment of osteoporosis, a condition characterized by low bone density and/or poor bone quality leading to an increased risk of fracture. Using either oral or intravenous formulations of this class of drug has led to successful treatment of this chronic metabolic disease with fracture risk reduction ranging from 47 to 70% for vertebral fractures, 28–50% for hip fractures, and 19–38% for other non-vertebral fractures. This is unique when you consider the polypharmacy necessary to manage other chronic illnesses such as diabetes or hypertension. Unique also to this class of drug is their accumulation in the target tissue, with binding in bone hydroxyapatite that can inhibit osteoclast function long after the drug has been discontinued. A third but more troublesome outcome of bisphosphonate use is the rare but seemingly, at least to patients, paradoxical increase of a rare type of femur fracture known as atypical femur fracture. …