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Guideline released for continuous use of bisphosphonates
New recommendations for the use of bisphosphonates for treating osteoporosis have been released by a task force of the American Society for Bone and Mineral Research.
The new guideline, published in the Journal of Bone and Mineral Research, recommends that clinicians reevaluate potential benefits and risks of the treatment after 5 years of oral or 3 years of IV bisphosphonate use. Potential benefits include continued reduction in the risk for vertebral fractures whereas risks may include osteonecrosis of the jaw and unusual fractures of the femur.
Continuation of treatment with oral bisphosphonates for up to 10 years or IV bisphosphonates for up to 6 years should be considered for older women with a high risk for fracture, those with previous major osteoporotic fractures and those who fracture on therapy. A drug holiday of 2 to 3 years after 3 to 5 years of treatment can be considered for women not at high risk for fracture.
“It is unlikely that there will ever be randomized controlled trials of osteoporosis patients of sufficient size and duration to provide clear evidence that a given strategy over the long term leads to fewer fractures,” Robert A. Adler, MD, of McGuire Veterans Affairs Medical Center and Virginia Commonwealth University School of Medicine, said in a news release.
Ghada El-Hajj Fuleihan , MD, MPH, of American University of Beirut Medican Center, added that “clinicians caring for patients with chronic osteoporosis will need to use the art in addition to the science of medicine.”
Disclosure: Adler reports financial ties with Amgen, Eli Lilly, Genentech, Merck and Novartis. Please see the full guidelines for a list of all other authors’ relevant financial disclosures.