New Recommendations for Bisphosphonate Therapy
A new guideline provides recommendations on the duration of bisphosphonate therapy in postmenopausal women with osteoporosis. The Task Force of the American Society for Bone and Mineral Research recommends treating women with 5 years of oral therapy or 3 years of annual infusion therapy and then reassessing risk. For women at high risk (those with a low T score or high fracture risk score, those with a previous major osteoporotic fracture, or those who fracture while on therapy), treatment may be extended up to 10 years for oral bisphosphonate or 6 years of yearly infusion bisphosphonate therapy. The guideline acknowledges that there is an increase in atypical fractures (but not osteonecrosis of the jaw) with continued therapy, but two studies have shown a significant reduction in major fractures in women at high risk with continued therapy. For women who are not at high risk after 3-5 years of bisphosphonate therapy, a drug holiday of 2-3 years may be considered. The same recommendations may be applicable to men with glucocorticoid-induced osteoporosis (J Bone Miner Res 2016;31:16-35, DOI 10.1002/jbmr.2708).
For women who are not at high risk after 3-5 years of bisphosphonate therapy, a drug holiday of 2-3 years may be considered.
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