Recent developments in bisphosphonate therapy.
OBJECTIVE
To provide a review of current developments in bisphosphonates indicated for the treatment of several rheumatologic conditions, including postmenopausal and glucocorticoid-induced osteoporosis.


METHODS
This review summarizes the pathology, diagnosis, and treatment of both postmenopausal and glucocorticoid-induced osteoporosis and examines the results of current clinical trials of the newest oral and intravenous formulations of nitrogen-containing bisphosphonates. We discuss important adverse events, including upper gastrointestinal symptoms and osteonecrosis of the jaw. Additionally, we explore methods that may improve patient adherence to bisphosphonate therapy, which is currently suboptimal.


RESULTS
Clinical studies have shown that oral bisphosphonates are efficacious in increasing bone mineral density and reducing risk of fracture. Despite concerns of upper gastrointestinal irritation, most of the newer oral bisphosphonates display a safety profile similar to placebo. Many of the newest formulations offer patients a choice in both dosing frequency and method of administration (either oral or intravenous).


CONCLUSIONS
Nitrogen-containing bisphosphonates are important therapeutic options for the prevention and treatment of osteoporosis.
Silverman
Stuart L
SL
UCLA/Cedars-Sinai, Osteoporosis Medical Center, Beverly Hills, California 90211, USA. stuarts@omcresearch.org
Maricic
Michael
M
D000818:Animals; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D004164:Diphosphonates / Q000627:therapeutic use*; D006801:Humans; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy*
D050071:Bone Density Conservation Agents; D004164:Diphosphonates