246
Views
0
CrossRef citations to date
0
Altmetric
Review

Optimum duration and safety of long-term use of potent anti-resorptive medications in osteoporosis

Pages 329-348 | Received 27 Jan 2016, Accepted 13 Jun 2016, Published online: 15 Jul 2016
 

ABSTRACT

Introduction: Anti-resorptive drugs are the most commonly used medications for treating metabolic bone diseases. These agents reduce the risk of osteoporosis fractures, control Paget’s disease, hypercalcemia of malignancy and bone metastasis. However, administration of high doses or long-term use are associated with rare but serious adverse effects.

Areas covered: Beyond 5 years of use, fracture reduction benefits of bisphosphonate and denosumab are minimal, while the incidence of serious adverse events increases. Thus the FDA recommends limiting treatment to less than 5 years. However, treating beyond 5 years with bisphosphonates or denosumab is appropriate in patients in whom the reduction of fracture benefits outweighs adverse effects. Detailed insight into safety and the duration of use of potent anti-resorptive agents are discussed.

Expert commentary: Considering the safety and effectiveness, in patients with osteoporosis and Paget’s disease of bone, the use of potent antiresorptive agents should be limited for five years and three years in patients with cancer to control the complications. An annual reassessment is recommended for patients with osteoporosis, and Paget’s disease these agents to (a) assess overall health, adherence to medication, and objective measures of improvements; (b) exclude secondary causes of bone loss; and (c) assess the need for continuation of receiving anti-resorptive therapy.

Declaration of interest

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This paper was not funded.

Log in via your institution

Log in to Taylor & Francis Online

PDF download + Online access

  • 48 hours access to article PDF & online version
  • Article PDF can be downloaded
  • Article PDF can be printed
USD 99.00 Add to cart

Issue Purchase

  • 30 days online access to complete issue
  • Article PDFs can be downloaded
  • Article PDFs can be printed
USD 608.00 Add to cart

* Local tax will be added as applicable

Related Research

People also read lists articles that other readers of this article have read.

Recommended articles lists articles that we recommend and is powered by our AI driven recommendation engine.

Cited by lists all citing articles based on Crossref citations.
Articles with the Crossref icon will open in a new tab.