A GP guide to bisphosphonate ‘treatment breaks’
Although bisphosphonates are safe overall in treating osteoporosis, treatment breaks are important to minimise the possible side-effects
Need to know:
Bisphosphonates are the most common class of antiresorptive medications used in the treatment of osteoporosis, with proven efficacy in improving bone mineral density (BMD) and reducing fracture risk.4
Bisphosphonates bind to active sites of the bone surface and impair the action of osteoclasts, the primary cell driving bone resorption.5-7 These agents accumulate in bone, leading to continued release from bone long after stopping treatment and recirculation in active resorption pits.8
Zoledronic acid is the most strongly bound to bone, followed by alendronate and risedronate.7,9 Clinically, this may account for differences between bisphosphonate agents in durability of anti-fracture effect once treatment is ceased.
