Bisphosphonates slow bone resorption by reducing osteoclast function. Many studies have shown that this class of medication can improve bone density and reduce the risk of fracture in patients with a reduced bone density.

Bisphosphonates should be used as first-line pharmacologic treatment for osteoporosis. In patients who cannot tolerate or whose symptoms do not improve with bisphosphonate therapy, teriparatide (Forteo) and denosumab (Prolia) are effective alternative medications to prevent osteoporotic fractures.

Use immediately after fracture — A history of a fragility (low-trauma) fracture is an important risk factor for subsequent fracture. If a patient is not already treated, pharmacologic therapy (typically bisphosphonates) should be initiated in patients with fragility fracture to prevent subsequent fracture [71].

Bisphosphonates are a group of drugs that can be used to help protect bones against the effects of some cancers and to treat some bone conditions. Sometimes bisphosphonates are called bone strengthening or bone hardening treatments.

The oral bisphosphonates alendronic acid and risedronate sodium are considered as first-line options for most patients with postmenopausal osteoporosis due to their broad spectrum of anti-fracture efficacy.

C: Based on a secondary analysis of a large randomized controlled trial. Bell KL, Hayen A, Macaskill P, et al. Value of routine monitoring of bone mineral density after starting bisphosphonate treatment: secondary analysis of treatment data. BMJ.

Bisphosphonates work by slowing down the cells which break down bone (osteoclasts). Therefore they slow down bone loss, allowing the bone building cells (osteoblasts) to work more effectively.

Patients on a dose equivalent of 2.5mg prednisone or greater for 3 months or longer duration should have their fracture risk assessed. Those at moderate or high risk should start bisphosphonate therapy, or if contraindicated, a second line agent such as teriparatide or denosumab.

Bisphosphonates Cause Brittle, Aged Bone With More Mineralization. The researchers first established that biopsies taken from patients who had developed an AFF showed evidence of elevated tissue mineralization.

DOI: 10.1016/j.amjmed.2012.06.023 Abstract The amino-bisphosphonates are first-line therapy for the treatment of most patients with osteoporosis, with proven efficacy to reduce fracture risk at the spine, hip, and other nonvertebral skeletal sites.

Bisphosphonates should be used as first-line pharmacologic treatment for osteoporosis. A. 16, 26. In patients who cannot tolerate or whose symptoms do not improve with bisphosphonate therapy, teriparatide (Forteo) and denosumab (Prolia) are effective alternative medications to prevent osteoporotic fractures.

Clinicians should consider discontinuing bisphosphonate therapy after five years in women without a personal history of vertebral fractures. Raloxifene, teriparatide, and denosumab are alternative effective treatments for certain subsets of patients and for those who are unable to take or whose condition does not respond to bisphosphonates.

Following the use of bisphosphonates in millions of patients in clinical practice, some unexpected possible adverse effects have been reported, including osteonecrosis of the jaw, atypical femur fractures, atrial fibrillation, and esophageal cancer.