Document Detail

Osteoporosis: how long should we treat?
MedLine Citation:
PMID:  18971678     Owner:  NLM     Status:  MEDLINE    
PURPOSE OF REVIEW: Bisphosphonates are the most commonly used treatment for osteoporosis. The pharmacology of bisphosphonates suggests the possibility of discontinuing treatment for a period, and patients frequently ask about this. In an attempt to help answer these questions, this review will consider recent data relevant to continuing and discontinuing long-term bisphoshonate therapy and other osteoporosis therapy.
RECENT FINDINGS: Morphometric vertebral fracture protection continues for 1 year after discontinuation of risedronate for 3 years and there are now similar bishosphonate data for hip fractures. Nonvertebral fractures -in high-risk women - and perhaps clinical vertebral fractures may be reduced in women treated for 10 years with alendronate compared with those who stopped treatment after 5 years. After discontinuing bisphosphonates, bone mineral density appears to deplete more rapidly in the spine than in the hip and biochemical markers appear to increase. These changes occur very rapidly after discontinuing denosumab. Fractures at unusual sites have been reported with long-term bisphosphonate use.
SUMMARY: It appears that a drug holiday can be considered in many patients, although high-risk patients may benefit from continued bisphosphonate therapy. Recent unusual fracture cases need to be considered in making long-term treatment decisions.
Anthony Sebba
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in endocrinology, diabetes, and obesity     Volume:  15     ISSN:  1752-2978     ISO Abbreviation:  Curr Opin Endocrinol Diabetes Obes     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-10-30     Completed Date:  2008-12-18     Revised Date:  2013-06-03    
Medline Journal Info:
Nlm Unique ID:  101308636     Medline TA:  Curr Opin Endocrinol Diabetes Obes     Country:  England    
Other Details:
Languages:  eng     Pagination:  502-7     Citation Subset:  IM    
University of South Florida, Tampa, Florida 34684, USA.
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MeSH Terms
Antibodies, Monoclonal / administration & dosage
Antibodies, Monoclonal, Humanized
Bone Density / drug effects
Bone Density Conservation Agents / administration & dosage*
Clinical Protocols / standards
Diphosphonates / administration & dosage*
Hip Fractures / prevention & control
Osteoporosis / drug therapy*
RANK Ligand / administration & dosage
Spinal Fractures / prevention & control
Withholding Treatment / standards,  utilization
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Humanized; 0/Bone Density Conservation Agents; 0/Diphosphonates; 0/RANK Ligand; 4EQZ6YO2HI/denosumab

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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