Benefits and risks of bisphosphonate therapy for osteoporosis

Sundeep Khosla, John P. Bilezikian, David W. Dempster, E. Michael Lewiecki, Paul D. Miller, Robert M. Neer, Robert R. Recker, Elizabeth Shane, Dolores Shoback, John T. Potts

Research output: Contribution to journalArticle

137 Citations (Scopus)

Abstract

Context: There has been considerable concern recently in the scientific and lay media regarding the benefits vs. the risks of bisphosphonates for the treatment of osteoporosis. Risks include possible associations with osteonecrosis of the jaw (ONJ) and atypical femur fractures. In this perspective, we review the use of bisphosphonates for the treatment of osteoporosis, including an objective assessment of the risks vs. the benefits of these drugs. Evidence Acquisition: Authors' knowledge of the field and results of focused literature searches are presented. Evidence Synthesis: Bisphosphonates have proven efficacy in the prevention of bone loss and in the reduction of fractures in postmenopausal women and men with established osteoporosis. Although bisphosphonates, at doses used to treat osteoporosis, may be associated with an increased risk of ONJ and atypical femur fractures, many more fractures are prevented by the use of these drugs compared to the relatively low risk of these complications. Although oral bisphosphonates are associated with upper gastrointestinal side effects and iv bisphosphonates with acute phase reactions, the association of bisphosphonate use with esophageal cancer and atrial fibrillation is not well supported by current data. Conclusions: Bisphosphonates have been proven to prevent fractures in patients with established osteoporosis or those who are at high risk of fracture. In contrast, the incidence of major complications associated with bisphosphonate use, such as ONJ and atypical femur fractures, is very low.

Original languageEnglish (US)
Pages (from-to)2272-2282
Number of pages11
JournalJournal of Clinical Endocrinology and Metabolism
Volume97
Issue number7
DOIs
StatePublished - Jul 2012

Fingerprint

Diphosphonates
Osteoporosis
Osteonecrosis
Jaw
Femur
Therapeutics
Fracture Fixation
Acute-Phase Reaction
Knowledge acquisition
Esophageal Neoplasms
Pharmaceutical Preparations
Atrial Fibrillation
Bone
Association reactions
Bone and Bones
Incidence

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism

Cite this

Khosla, S., Bilezikian, J. P., Dempster, D. W., Lewiecki, E. M., Miller, P. D., Neer, R. M., ... Potts, J. T. (2012). Benefits and risks of bisphosphonate therapy for osteoporosis. Journal of Clinical Endocrinology and Metabolism, 97(7), 2272-2282. https://doi.org/10.1210/jc.2012-1027

Benefits and risks of bisphosphonate therapy for osteoporosis. / Khosla, Sundeep; Bilezikian, John P.; Dempster, David W.; Lewiecki, E. Michael; Miller, Paul D.; Neer, Robert M.; Recker, Robert R.; Shane, Elizabeth; Shoback, Dolores; Potts, John T.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 97, No. 7, 07.2012, p. 2272-2282.

Research output: Contribution to journalArticle

Khosla, S, Bilezikian, JP, Dempster, DW, Lewiecki, EM, Miller, PD, Neer, RM, Recker, RR, Shane, E, Shoback, D & Potts, JT 2012, 'Benefits and risks of bisphosphonate therapy for osteoporosis', Journal of Clinical Endocrinology and Metabolism, vol. 97, no. 7, pp. 2272-2282. https://doi.org/10.1210/jc.2012-1027
Khosla, Sundeep ; Bilezikian, John P. ; Dempster, David W. ; Lewiecki, E. Michael ; Miller, Paul D. ; Neer, Robert M. ; Recker, Robert R. ; Shane, Elizabeth ; Shoback, Dolores ; Potts, John T. / Benefits and risks of bisphosphonate therapy for osteoporosis. In: Journal of Clinical Endocrinology and Metabolism. 2012 ; Vol. 97, No. 7. pp. 2272-2282.
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