Safety of Bisphosphonates in the Treatment of Osteoporosis

School of Medicine, Creighton University, Omaha, Nebraska, USA.
The American journal of medicine (Impact Factor: 5.3). 03/2009; 122(2 Suppl):S22-32. DOI: 10.1016/j.amjmed.2008.12.004
Source: PubMed

ABSTRACT In this review 4 experts consider the major safety concerns relating to bisphosphonate therapy for osteoporosis. Specific topics covered are skeletal safety (particularly with respect to atypical fractures and delayed healing), gastrointestinal intolerance, hypocalcemia, acute-phase (i.e., postdose) reactions, chronic musculoskeletal pain, renal safety, and cardiovascular safety (specifically, atrial fibrillation).

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    • "In these two controlled studies, the profile was safe, with a number of serious adverse events or deaths not significantly different in the groups treated with ZA or with PBO. A major problem with ZA was the postinfusion syndrome, which is classical with all intravenous BP following the first infusion, usually mild, and can be reduced by acetaminophen [66]. Intriguingly, an unexpected number of episodes of atrial fibrillation described as severe adverse events occurred in the ZA-treated group. "
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    ABSTRACT: During the past 2 decades, many interventions were proven effective in the management of postmenopausal osteoporosis. The objective of an anti-osteoporosis treatment is to reduce fracture rates, ideally at all skeletal sites (i.e. spine, hip, and other non-spine). The armamentarium against osteoporosis includes anti-resorptive agents (i.e. bisphosphonates, selective estrogen receptor modulators and denosumab), bone-forming agents (i.e. peptides from the parathyroid hormone family) and one agent with a dual mechanism of action (i.e. strontium ranelate). All these medications combine anti-fracture efficacy with a reasonable benefit/risk profile. However, the choice of a particular chemical entity, in one individual patient is based on the knowledge and expertise of the physician. Prioritization of drugs should be based on the individual profile of the patient, the severity of osteoporosis and the specific contraindications, warnings and precautions of use of the various available medications.
    Best Practice & Research: Clinical Endocrinology & Metabolism 12/2014; 28(6). DOI:10.1016/j.beem.2014.09.003 · 4.91 Impact Factor
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    • "Bisphosphonates taken orally, once a week or once a month, include alendronate (Fosamax), ibandronate (Boniva), and risedronate (Actonel). Bisphosphonates given through a vein (intravenously) are taken less often (Gass and Dawson-Hughes, 2006; Recker et al., 2009; Society, 2003). Bisphosphonates inhibit bone resorption and are therapeutically effective in diseases of increased bone turnover, such as Paget's disease and hypercalcemia of malignancy (Hughes et al., 1995). "
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    ABSTRACT: Osteoporosis is one of the most common bone diseases that occur due to imbalance during bone formation and bone resorption. About half of all women over the age of 50 will have a fracture on the hip, wrist, or vertebra. Research and treatment of osteoporosis are challenging for researchers and physicians. There are several types of treatments for osteoporosis including most famous bisphosphonates, estrogen agonists/antagonists, parathyroid hormone, estrogen therapy, hormone therapy, and recently developed RANKL inhibition. In the recent days, much attention has been paid for marine algal extracts and compounds for osteoporosis treatment. In this chapter, we extensively deal with marine algae compounds and their rich mineral constituents for osteoporosis treatment.
    Advances in food and nutrition research 01/2011; 64:417-27. DOI:10.1016/B978-0-12-387669-0.00032-6
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    ABSTRACT: Bisphosphonate treatment and its aetiopathogenic association with aseptic osteonecrosis of the jaw is one of the more prominent public health issues today. The aim of this review is to see into the mechanisms of bisphosphonate effects on bones described in literature (anti-osteoclastic activity, cytotoxicity, antiangiogenesis, genetic factors, and imbalance between osteoclasts and osteoblasts). Bisphosphonate treatment is the dominant cause of jaw necrosis. Epidemiological data show an exclusive incidence of osteonecrosis of the jaw in patients who took one or a combination of nitrogen-containing bisphosphonates. Risk factors vary by the bisphosphonate potency (particularly risky are the highly potent pamidronate and zoledronate, which are given intravenously), dosage, duration of treatment, and the illness. Jaw necrosis is most common in oncology patients, and only 5 % in patients with osteoporosis. From a dental-medical point of view, a good oral health is important because osteonecrosis often appears after a periodontal or oral surgical procedure.
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