Adverse effects of bisphosphonates: Implications for osteoporosis management

Kennel, Kurt A.; Drake, Matthew T.

doi:10.1016/s0025-6196(11)60752-0

Cited by 496Bone health and osteoporosis researchBone health and treatmentsMenopause: Health Impacts and Treatments

Adverse effects of bisphosphonates: Implications for osteoporosis management

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Kennel, Kurt A., Drake, Matthew T.·2009·Mayo Clinic Proceedings

DOI 10.1016/s0025-6196(11)60752-0PMC PMC2704135

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Abstract

Bisphosphonates are widely prescribed and highly effective at limiting the bone loss that occurs in many disorders characterized by increased osteoclast-mediated bone resorption, including senile osteoporosis in both men and women, glucocorticoid-associated osteoporosis, and malignancies metastatic to bone. Although they are generally well tolerated, potential adverse effects may limit bisphosphonate use in some patients. Optimal use of bisphosphonates for osteoporosis requires adequate calcium and vitamin D intake before and during therapy. The World Health Organization fracture risk assessment algorithm is currently available to determine absolute fracture risk in patients with low bone mass and is a useful tool for clinicians in identifying patients most likely to benefit from pharmacological intervention to limit fracture risk. This fracture risk estimate may facilitate shared decision making, especially when patients are wary of the rare but serious adverse effects that have recently been described for this class of drugs.

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Traditional drug therapy for skeletal diseases is mainly based on inhibiting osteoclast formation or inhibiting osteoclast activity.
“Traditional drug therapy for diseases of the skeletal system is mainly based on inhibiting osteoclast formation (estrogen, etc.) or inhibiting osteoclast activity (bisphosphonates, etc.).”
From The Therapeutic Potential and Clinical Significance of Exosomes as Carriers of Drug Delivery System (2022) · cites this paper as [84]
Prolonged use of high doses of drugs for skeletal diseases can cause secondary adverse effects, including affecting normal osteocytes.
“However, the prolonged use of high doses of drugs that can cause secondary adverse effects, including affecting normal osteocytes [84].”
From The Therapeutic Potential and Clinical Significance of Exosomes as Carriers of Drug Delivery System (2022) · cites this paper as [84]

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Authors: Kennel, K. A., & Drake, M. T.
Affiliations: Mayo Clinic (US)
Corresponding author: Drake, Matthew T.
ORCID: Kennel, Kurt A.
Drake, Matthew T.
Venue: Mayo Clinic Proceedings
Publisher: Elsevier BV
Published: 2009-07
Volume: 84
Issue: 7
Pages: 632-638
ISSN: 0025-6196 (ISSN-L)
DOI: 10.1016/s0025-6196(11)60752-0
PMC: PMC2704135
OpenAlex: W4252350389
Cited by: 496
References: 29
Citations by year: 2026: 12 · 2025: 32 · 2024: 42 · 2023: 38 · 2022: 42 · 2021: 40 · 2020: 45 · 2019: 47 · 2018: 45 · 2017: 30 · 2016: 32 · 2015: 17 · 2014: 10 · 2013: 18 · 2012: 15
FWCI: 2.68
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Mayo Clinic Proceedings (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
Health Sciences › Medicine › Oncology › Bone health and treatments
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
Keywords: bisphosphonates, adverse effects, osteoporosis management, glucocorticoid-induced osteoporosis, bone metastasis, senile osteoporosis, calcium and vitamin D supplementation, fracture risk assessment, shared decision-making, drug safety
MeSH terms: Aged, Algorithms, Diphosphonates, Drug Administration Schedule, Female, Humans, Male, Middle Aged, Osteoporosis, Risk Assessment, Bone Density Conservation Agents, Fractures, Bone

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Adverse effects of bisphosphonates: Implications for osteoporosis management

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