Osteoporosis and Bisphosphonates (Fosamax, Boniva, ReClast, etc)
Gerti Tashko, MD
Your Comprehensive Endocrinologist | Board Certified in Lipidology, Hypertension, and Obesity
“The American Society for Bone and Mineral Research (ASBMR) has published guidance on managing osteoporosis in patients on long-term bisphosphonate treatment. An ASBMR task force acknowledged a dearth of evidence in this area, and noted that it presents management suggestions based on limited data and clinical experience.
ASBMR relied on 2 trials for evidence: The Fracture Intervention Trial Long-term Extension, and the HORIZON extension.
The task force suggests that reassessment be considered after 5 years of oral bisphosphonate or 3 years of intravenous bisphosphonate therapy. For women at high risk of fracture, consider continuation of treatment for up to 10 years (oral) or 6 years (intravenous), with periodic evaluation. For women not at high fracture risk after 3 to 5 years of treatment, consider a drug holiday of 2 to 3 years.
Owing to the lack of evidence, the task force includes in its statement cases that demonstrate how individualization of management can be achieved.”