49. Bisphosphonates for Postmenopausal Osteoporosis

  1. Clifford J. Rosen MD
  1. Socrates E. Papapoulos

Published Online: 19 JUL 2013

DOI: 10.1002/9781118453926.ch49

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition

How to Cite

Papapoulos, S. E. (2013) Bisphosphonates for Postmenopausal Osteoporosis, in Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition (ed C. J. Rosen), John Wiley & Sons, Inc., Ames, USA. doi: 10.1002/9781118453926.ch49

Publication History

  1. Published Online: 19 JUL 2013

ISBN Information

Print ISBN: 9781118453889

Online ISBN: 9781118453926

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Keywords:

  • antifracture efficacy;
  • bisphosphonates (BPs);
  • bone fragility;
  • postmenopausal osteoporosis;
  • skeletal fragility

Summary

Bisphosphonates (BPs), because of their efficacy, safety, and ease of administration, are generally accepted as first-line therapy for postmenopausal osteoporosis. BPs are synthetic analogs of inorganic pyrophosphate in which the oxygen atom that connects the two phosphates is replaced by a carbon. This substitution renders BPs resistant to biological degradation and suitable for clinical use. BPs have two additional side chains that allow the synthesis of many analogs with different pharmacological properties. The overall efficacy and consistency of BPs in reducing the risk of vertebral fractures has been demonstrated by meta-analyses of randomized controlled trials (RCTs) for alendronate and risedronate. Skeletal fragility on long-term BP therapy has been examined in extensions of four clinical trials for 6 to 10 years. Study results suggest that alendronate treatment should be continued in patients at high risk whereas discontinuation of treatment after 5 years can be considered in patients with lower fracture risk.