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01-03-2016 | Editorial

Bisphosphonate drug holidays: we reap what we sow

Authors: S. L. Silverman, J. D. Adachi, E. Dennison, And the International Osteoporosis Foundation Epidemiology/Quality of Life Working Group

Published in: Osteoporosis International | Issue 3/2016

Excerpt

The concept that our patients need to interrupt or stop bisphosphonate therapy for osteoporosis after 5 years of oral bisphosphonate therapy and after 3 years of intravenous bisphosphonate therapy has gained considerable traction worldwide. It has been our observation that some physicians (and even entire health authority regions) are automatically stopping bisphosphonates in patients who are taking osteoporosis medication without consideration for the patient’s risk of fracture. In addition, some physicians have mistakenly extended this concept to other antiresorptives such as raloxifene and denosumab where bone density gains are quickly lost with discontinuation. …

Black DM, Schwartz AV, Ensrud KE, Schwartz AV, Ensrud KE, Cauley JA, Levis S, Quandt SA, Satterfield S, Wallace RB, Bauer DC, Palermo L, Wehren LE, Lombardi A, Santora AC, Cummings SR; FLEX Research Group (2006) Effects of continuing or stopping alendronate after 5 years of treatment: the fracture intervention trial long-term extension (FLEX): a randomized trial. JAMA 296:2927–2938CrossRef

Whitaker M, Guo J, Kehoe T, Benson G (2012) Bisphosphonates for osteoporosis—where do we go from here? NEJM 366:2048–2051CrossRefPubMed

Russell R, Watts N, Ebetino F, Rogers M (2008) Mechanisms of action of bisphosphonates: similarities and differences and their potential influence on clinical efficacy. Osteopor Int 19:733–759CrossRef

Rodan G, Reszka A, Golub E, Rizzoli R (2004) Bone safety of long term bisphosphonate treatment. Curr Med Res Opin 20:1291–1300CrossRefPubMed

Lo JC, O'Ryan FS, Gordon NP et al (2010) Prevalence of osteonecrosis of the jaw in patients with oral bisphosphonate exposure. J Oral Maxillofac Surg 68:243–253CrossRefPubMed

Dell RM, Adams AL, Greene DF, Funahashi TT, Silverman SL, Eisemon EO, Zhou H, Burchette RJ, Ott SM (2012) Incidence of atypical nontraumatic diaphyseal fractures of the femur. J Bone Miner Res 27:2544–2550CrossRefPubMed

Khosla S, Burr D, Cauley J, Dempster DW, Ebeling PR, Felsenberg D, Gagel RF, Gilsanz V, Guise T, Koka S, McCauley LK, McGowan J, McKee MD, Mohla S, Pendrys DG, Raisz LG, Ruggiero SL, Shafer DM, Shum L, Silverman SL, Van Poznak CH, Watts N, Woo SB, Shane E (2010) American society for bone and mineral research. Bisphosphonate-associated osteonecrosis of the jaw: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res 22:1479–1491CrossRef

Schilcher J, Koeppen V, Aspenberg P, Michaëlsson K (2014) Risk of atypical femoral fracture during and after bisphosphonate use. N Engl J Med 371:974–976CrossRefPubMed

Schilcher J, Koeppen V, Aspenberg P, Michaëlsson K (2015) Risk of atypical femoral fracture during and after bisphosphonate use. Acta Orthop 86:100–107CrossRefPubMedPubMedCentral

10.

American Association of Oral and Maxillofacial Surgeons (2014) Medication related osteonecrosis of the jaw-2014 Update. www.asoms.org/images/uploads/PDFs/mronj-position-paper.pdf accessed November 11, 2013

11.

Lyles KW, Colón-Emeric CS, Magaziner JS, Adachi JD, Pieper CF, Mautalen C, Hyldstrup L, Recknor C, Nordsletten L, Moore KA, Lavecchia C, Zhang J, Mesenbrink P, Hodgson PK, Abrams K, Orloff JJ, Horowitz Z, Eriksen EF, Boonen S (2007) HORIZON recurrent fracture trial. Zoledronic acid and clinical fractures and mortality after hip fracture. N Engl J Med 357:1799–1809CrossRefPubMed

12.

Sambrook PN, Cameron ID, Chen JS, March LM, Simpson JM, Cumming RG, Seibel MJ (2011) Oral bisphosphonates are associated with reduced mortality in frail older people: a prospective five-year study. Osteoporos Int 22:2551–2556CrossRefPubMed

13.

Watts NB, Chines A, Olszynski WP, McKeever CD, McClung MR, Zhou X, Grauer A (2008) Fracture risk remains reduced one year after discontinuation of risedronate. Osteoporos Int 19:365–372CrossRefPubMed

14.

Black DM, Reid IR, Boonen S, Bucci-Rechtweg C, Cauley JA, Cosman F, Cummings SR, Hue TF, Lippuner K, Lakatos P, Leung PC, Man Z, Martinez RL, Tan M, Ruzycky ME, Su G, Eastell R (2012) The effect of 3 versus 6 years of zoledronic acid treatment of osteoporosis: a randomized extension to the HORIZON-pivotal fracture trial (PFT). J Bone Miner Res 27:243–254CrossRefPubMed

15.

Black DM, Reid IR, Cauley JA, Cosman F, Leung PC, Lakatos P, Lippuner K, Cummings SR, Hue TF, Mukhopadhyay A, Tan M, Aftring RP, Eastell R (2015) The effect of 6 versus 9 years of zoledronic acid treatment in osteoporosis: a randomized second extension to the HORIZON-pivotal fracture trial (PFT). J Bone Miner Res 30:934–944CrossRefPubMed

16.

Diab DL, Watts NB (2013) Bisphosphonate drug holiday: who, when and how long. Ther Adv Musculoskelet Dis 5:107–111CrossRefPubMedPubMedCentral

17.

Cosman F, Cauley JA, Eastell R, Boonen S, Palermo L, Reid IR, Cummings SR, Black DM (2014) Reassessment of fracture risk in women after three years of treatment with zoledronic acid: when is it reasonable to discontinue treatment. J Clin Endocrinol Metab 99:4546–4554CrossRefPubMed

18.

McNabb BL, Vittinghoff E, Schwartz AV, Eastell R, Bauer DC, Ensrud K, Rosenberg E, Santora A, Barrett-Connor E, Black DM (2013) BMD changes and predictors of increased bone loss in postmenopausal women after a 5-year course of alendronate. J Bone Miner Res 28:1319–1327CrossRefPubMed

19.

Bauer DC, Schwartz A, Palermo L, Cauley J, Hochberg M, Santora A, Cummings SR, Black DM (2014) Fracture prediction afer discontinuation of 4 to 5 years of alendronate therapy The FLEX study. JAMA 174:1126–1134

20.

Solomon DH, Johnston SS, Boyston NH, McMorrow D, Lane JM, Krohn KD (2014) Osteoporosis medication after hip fracture in US. J Bone Miner Res 29:1929–1937CrossRefPubMedPubMedCentral

21.

Hernlund E, Svedbom A, Ivergård M, Compston J, Cooper C, Stenmark J, McCloskey EV, Jönsson B, Kanis JA (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 8:136CrossRefPubMedPubMedCentral

22.

Kanis JA, Svedbom A, Harvey N, McCloskey EV (2014) The osteoporosis treatment gap. J Bone Miner Res 29:1926–1928CrossRefPubMed

Title: Bisphosphonate drug holidays: we reap what we sow
Authors: S. L. Silverman
J. D. Adachi
E. Dennison
And the International Osteoporosis Foundation Epidemiology/Quality of Life Working Group
Publication date: 01-03-2016
Publisher: Springer London
Published in: Osteoporosis International / Issue 3/2016
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-015-3453-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Bisphosphonate drug holidays: we reap what we sow

Excerpt

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Excerpt

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