title: Long-term risks of bisphosphonate therapy.
abstract: The objective this study was to summarize long-term risks associated with bisphosphonate therapy. Search of relevant medical publications for data from clinical trials, trial extensions, observational studies and post-marketing reports. Trial extensions and modifications did not reveal significant long-term safety issues. Observational data suggest at least as many benefits as risks. Post-marketing reports of musculoskeletal pain, osteonecrosis of the jaw and atypical femur fractures have been widely circulated in the lay press. Most focus on long-terms risks has been on osteonecrosis of the jaw and atypical femur fractures which occur in patients who have not received bisphosphonate therapy but may be more frequent (though still uncommon) in patients who have been on treatment for 5 years or longer. Lower-risk patients may be able to stop treatment after 3-5 years for a "drug holiday," which mitigates these long-term risks; for higher risk patients, therapy through 6-10 years appears to be advisable and offers more benefits than risks.
authors.affiliation: Mercy Health Osteoporosis and Bone Health Services, Cincinnati, United States.
authors.forename: Nelson B
authors.initials: NB
authors.lastname: Watts
mesh_terms: D001281:Atrial Fibrillation / Q000139:chemically induced; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000209:etiology; D050071:Bone Density Conservation Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002277:Carcinoma / Q000139:chemically induced; D002986:Clinical Trials as Topic; D004164:Diphosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D004938:Esophageal Neoplasms / Q000139:chemically induced; D005264:Femoral Fractures / Q000139:chemically induced; D006801:Humans; D008134:Long-Term Care; D059352:Musculoskeletal Pain / Q000139:chemically induced; D010020:Osteonecrosis / Q000139:chemically induced; D010024:Osteoporosis / Q000188:drug therapy*; D065840:Protective Factors; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates