Pharmacological therapy of osteoporosis with bisphosphonates – for whom, what kind, and for how long?

Abstract

For many years bisphosphonates (BS) have played an important role in the treatment of postmenopausal osteoporosis. Additionally, they have recently been used in men and induced osteoporosis by administering glucocorticoids and some other secondary osteoporosis. Designing pharmacologically equivalent BS substance administered orally once a week or once a month allowed to reduce side effects related to the digestive system. Availability of intravenous BS substance resulted in a more frequent occurrence of the acute phase reactions. Recently a relation has been noticed between the use of BS and the occurrence of complications including osteonecrosis of the jaw and atypical subtrochanteric fractures. In this article the authors present current knowledge regarding BS treatment in osteoporosis and some adverse effects related to its long-term use. This information will help to optimize the length of treatment with BS and to make a decision about potential discontinuation of BS treatment.

Keywords

• osteoporosis
• bisphosphonates
• drug safety