How Long Should Women with Postmenopausal Osteoporosis be Treated with a Bisphosphonate?

K. Kerschan-Schindl; J. Haschka; B. Obermayer-Pietsch; R. W. Gasser; H.-P. Dimai; A. Fahrleitner-Pammer; H. Dobnig; P. Roschger; E. Preisinger; K. Klaushofer; H. Resch; P. Pietschmann

doi:10.1055/s-0033-1345207

Hormone and Metabolic Research, Table of Contents

Horm Metab Res 2013; 45(09): 621-628
DOI: 10.1055/s-0033-1345207

Review

How Long Should Women with Postmenopausal Osteoporosis be Treated with a Bisphosphonate?

K. Kerschan-Schindl

¹Department of Physical Medicine & Rehabilitation, Medical University of Vienna, Vienna, Austria

,

J. Haschka

²Department II Rheumatology/ Osteology & Gastroenterology, St Vincent Hospital, Vienna, Austria

,

B. Obermayer-Pietsch

³Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria

,

R. W. Gasser

⁴Department of Internal Medicine I, Medical University of Innsbruck, Innsbruck, Austria

,

H.-P. Dimai

³Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria

,

A. Fahrleitner-Pammer

³Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria

,

H. Dobnig

⁵Schilddrüsen Endokrinologie Osteoporose Institut Dobnig GmbH, Graz, Austria

,

P. Roschger

⁶1st Medical Department, and Ludwig Boltzmann Institute of Osteology, Hanusch Hospital, Vienna, Austria

,

E. Preisinger

⁷Institute for Physical Medicine and Rehabilitation, Krankenhaus Hietzing mit Neurologischem Zentrum Rosenhügel, Vienna, Austria

,

K. Klaushofer

⁶1st Medical Department, and Ludwig Boltzmann Institute of Osteology, Hanusch Hospital, Vienna, Austria

,

H. Resch

²Department II Rheumatology/ Osteology & Gastroenterology, St Vincent Hospital, Vienna, Austria

,

P. Pietschmann

⁸Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria

› Author Affiliations

Abstract

Bisphosphonates are very frequently prescribed to women suffering from postmenopausal osteoporosis with or without fragility fractures. The present review was aimed to update the available information on the most efficient treatment duration. Studies on bisphosphonate treatment duration were identified by Medline up to January 2013. Bisphosphonates are very effective in the short as well as in the medium-term. However, the optimal duration of use has not been determined yet. Therefore, this review summarizes the long-term effects of bisphosphonates on surrogate parameters of fracture prevention, bone mineral density measurements, and bone turnover markers. An initial treatment period of 3–5 years is recommended. Then, the patient has to be re-evaluated for fracture risk, which depends on fracture status as well as on other health issues. Beyond that, life style factors such as regular physical activity as well as a sufficient intake of calcium and vitamin D or, if necessary supplementation of calcium and/or vitamin D play an essential part in fracture prevention.

Key words

bisphosphonate - long-term treatment - biomarkers - bone mineral density - bone mineralization density distribution - fragility fracture

Full Text

References

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