Benefits and Risks of Bisphosphonate Therapy for Osteoporosis
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,...
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| Veröffentlicht in: | The journal of clinical endocrinology and metabolism 2012-07, Vol.97 (7), p.2272-2282 |
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| container_title | The journal of clinical endocrinology and metabolism |
| container_volume | 97 |
| creator | 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 |
| description | 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. |
| doi_str_mv | 10.1210/jc.2012-1027 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1611623450</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1024349385</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5479-6604e6f7a9b7d1ce9d7e2201a6608b68c58fdd3b08a821f140c773d706fd808a3</originalsourceid><addsrcrecordid>eNqFkE1r3DAQhkVpSbZpbj0XXwo91Km-LMmHHpqQJoFAoKTQm9BKI9Ybr-VqbEL-fWR2214KEQihmeedj5eQ94yeMc7ol60_45TxmlGuX5EVa2VTa9bq12RFKWd1q_mvY_IWcUspk7IRR-SY84YLIfSKfD2HAWI3YeWGUP3o8AGrFKvzDsdNWu7gJqjuN5Dd-FTFlKs7nCCNKSfs8B15E12PcHp4T8jP75f3F9f17d3VzcW329o3Ure1UlSCitq1ax2YhzZo4GVoVxJmrYxvTAxBrKlxhrPIJPVai6CpisGUoDghn_Z1x5x-z4CT3XXooe_dAGlGyxRjigvZ0JdRyqWQrTBNQT_vUV-WwQzRjrnbufxUILt4a7feLt4uIl3wD4fK83oH4S_8x8wCfDwADr3rY3aD7_Afpxg3lC195Z57TP0EGR_6-RGy3YDrp42l5UilTb10prr86iXUFpnYy2AIyedugDEDot2mOQ_F_f9P_QwzrKAD</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1024349385</pqid></control><display><type>article</type><title>Benefits and Risks of Bisphosphonate Therapy for Osteoporosis</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><source>Journals@Ovid Complete</source><creator>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</creator><creatorcontrib>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</creatorcontrib><description>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.</description><identifier>ISSN: 0021-972X</identifier><identifier>EISSN: 1945-7197</identifier><identifier>DOI: 10.1210/jc.2012-1027</identifier><identifier>PMID: 22523337</identifier><identifier>CODEN: JCEMAZ</identifier><language>eng</language><publisher>Bethesda, MD: Endocrine Society</publisher><subject>Biological and medical sciences ; Bone Density Conservation Agents - adverse effects ; Bone Density Conservation Agents - pharmacology ; Bone Density Conservation Agents - therapeutic use ; Diphosphonates - adverse effects ; Diphosphonates - pharmacology ; Diphosphonates - therapeutic use ; Endocrinopathies ; Feeding. Feeding behavior ; Female ; Femoral Neck Fractures - chemically induced ; Femoral Neck Fractures - epidemiology ; Fundamental and applied biological sciences. Psychology ; Humans ; Jaw Diseases - chemically induced ; Jaw Diseases - epidemiology ; Male ; Medical sciences ; Models, Biological ; Osteonecrosis - chemically induced ; Osteonecrosis - epidemiology ; Osteoporosis - drug therapy ; Risk Assessment ; Vertebrates: anatomy and physiology, studies on body, several organs or systems ; Vertebrates: endocrinology</subject><ispartof>The journal of clinical endocrinology and metabolism, 2012-07, Vol.97 (7), p.2272-2282</ispartof><rights>Copyright © 2012 by The Endocrine Society</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5479-6604e6f7a9b7d1ce9d7e2201a6608b68c58fdd3b08a821f140c773d706fd808a3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26128015$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22523337$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Khosla, Sundeep</creatorcontrib><creatorcontrib>Bilezikian, John P</creatorcontrib><creatorcontrib>Dempster, David W</creatorcontrib><creatorcontrib>Lewiecki, E. Michael</creatorcontrib><creatorcontrib>Miller, Paul D</creatorcontrib><creatorcontrib>Neer, Robert M</creatorcontrib><creatorcontrib>Recker, Robert R</creatorcontrib><creatorcontrib>Shane, Elizabeth</creatorcontrib><creatorcontrib>Shoback, Dolores</creatorcontrib><creatorcontrib>Potts, John T</creatorcontrib><title>Benefits and Risks of Bisphosphonate Therapy for Osteoporosis</title><title>The journal of clinical endocrinology and metabolism</title><addtitle>J Clin Endocrinol Metab</addtitle><description>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.</description><subject>Biological and medical sciences</subject><subject>Bone Density Conservation Agents - adverse effects</subject><subject>Bone Density Conservation Agents - pharmacology</subject><subject>Bone Density Conservation Agents - therapeutic use</subject><subject>Diphosphonates - adverse effects</subject><subject>Diphosphonates - pharmacology</subject><subject>Diphosphonates - therapeutic use</subject><subject>Endocrinopathies</subject><subject>Feeding. Feeding behavior</subject><subject>Female</subject><subject>Femoral Neck Fractures - chemically induced</subject><subject>Femoral Neck Fractures - epidemiology</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Humans</subject><subject>Jaw Diseases - chemically induced</subject><subject>Jaw Diseases - epidemiology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Models, Biological</subject><subject>Osteonecrosis - chemically induced</subject><subject>Osteonecrosis - epidemiology</subject><subject>Osteoporosis - drug therapy</subject><subject>Risk Assessment</subject><subject>Vertebrates: anatomy and physiology, studies on body, several organs or systems</subject><subject>Vertebrates: endocrinology</subject><issn>0021-972X</issn><issn>1945-7197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1r3DAQhkVpSbZpbj0XXwo91Km-LMmHHpqQJoFAoKTQm9BKI9Ybr-VqbEL-fWR2214KEQihmeedj5eQ94yeMc7ol60_45TxmlGuX5EVa2VTa9bq12RFKWd1q_mvY_IWcUspk7IRR-SY84YLIfSKfD2HAWI3YeWGUP3o8AGrFKvzDsdNWu7gJqjuN5Dd-FTFlKs7nCCNKSfs8B15E12PcHp4T8jP75f3F9f17d3VzcW329o3Ure1UlSCitq1ax2YhzZo4GVoVxJmrYxvTAxBrKlxhrPIJPVai6CpisGUoDghn_Z1x5x-z4CT3XXooe_dAGlGyxRjigvZ0JdRyqWQrTBNQT_vUV-WwQzRjrnbufxUILt4a7feLt4uIl3wD4fK83oH4S_8x8wCfDwADr3rY3aD7_Afpxg3lC195Z57TP0EGR_6-RGy3YDrp42l5UilTb10prr86iXUFpnYy2AIyedugDEDot2mOQ_F_f9P_QwzrKAD</recordid><startdate>201207</startdate><enddate>201207</enddate><creator>Khosla, Sundeep</creator><creator>Bilezikian, John P</creator><creator>Dempster, David W</creator><creator>Lewiecki, E. Michael</creator><creator>Miller, Paul D</creator><creator>Neer, Robert M</creator><creator>Recker, Robert R</creator><creator>Shane, Elizabeth</creator><creator>Shoback, Dolores</creator><creator>Potts, John T</creator><general>Endocrine Society</general><general>Copyright by The Endocrine Society</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7QP</scope></search><sort><creationdate>201207</creationdate><title>Benefits and Risks of Bisphosphonate Therapy for Osteoporosis</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5479-6604e6f7a9b7d1ce9d7e2201a6608b68c58fdd3b08a821f140c773d706fd808a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Biological and medical sciences</topic><topic>Bone Density Conservation Agents - adverse effects</topic><topic>Bone Density Conservation Agents - pharmacology</topic><topic>Bone Density Conservation Agents - therapeutic use</topic><topic>Diphosphonates - adverse effects</topic><topic>Diphosphonates - pharmacology</topic><topic>Diphosphonates - therapeutic use</topic><topic>Endocrinopathies</topic><topic>Feeding. Feeding behavior</topic><topic>Female</topic><topic>Femoral Neck Fractures - chemically induced</topic><topic>Femoral Neck Fractures - epidemiology</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Humans</topic><topic>Jaw Diseases - chemically induced</topic><topic>Jaw Diseases - epidemiology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Models, Biological</topic><topic>Osteonecrosis - chemically induced</topic><topic>Osteonecrosis - epidemiology</topic><topic>Osteoporosis - drug therapy</topic><topic>Risk Assessment</topic><topic>Vertebrates: anatomy and physiology, studies on body, several organs or systems</topic><topic>Vertebrates: endocrinology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Khosla, Sundeep</creatorcontrib><creatorcontrib>Bilezikian, John P</creatorcontrib><creatorcontrib>Dempster, David W</creatorcontrib><creatorcontrib>Lewiecki, E. Michael</creatorcontrib><creatorcontrib>Miller, Paul D</creatorcontrib><creatorcontrib>Neer, Robert M</creatorcontrib><creatorcontrib>Recker, Robert R</creatorcontrib><creatorcontrib>Shane, Elizabeth</creatorcontrib><creatorcontrib>Shoback, Dolores</creatorcontrib><creatorcontrib>Potts, John T</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Calcium & Calcified Tissue Abstracts</collection><jtitle>The journal of clinical endocrinology and metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Khosla, Sundeep</au><au>Bilezikian, John P</au><au>Dempster, David W</au><au>Lewiecki, E. Michael</au><au>Miller, Paul D</au><au>Neer, Robert M</au><au>Recker, Robert R</au><au>Shane, Elizabeth</au><au>Shoback, Dolores</au><au>Potts, John T</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Benefits and Risks of Bisphosphonate Therapy for Osteoporosis</atitle><jtitle>The journal of clinical endocrinology and metabolism</jtitle><addtitle>J Clin Endocrinol Metab</addtitle><date>2012-07</date><risdate>2012</risdate><volume>97</volume><issue>7</issue><spage>2272</spage><epage>2282</epage><pages>2272-2282</pages><issn>0021-972X</issn><eissn>1945-7197</eissn><coden>JCEMAZ</coden><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.</abstract><cop>Bethesda, MD</cop><pub>Endocrine Society</pub><pmid>22523337</pmid><doi>10.1210/jc.2012-1027</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0021-972X |
| ispartof | The journal of clinical endocrinology and metabolism, 2012-07, Vol.97 (7), p.2272-2282 |
| issn | 0021-972X 1945-7197 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1611623450 |
| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection; Journals@Ovid Complete |
| subjects | Biological and medical sciences Bone Density Conservation Agents - adverse effects Bone Density Conservation Agents - pharmacology Bone Density Conservation Agents - therapeutic use Diphosphonates - adverse effects Diphosphonates - pharmacology Diphosphonates - therapeutic use Endocrinopathies Feeding. Feeding behavior Female Femoral Neck Fractures - chemically induced Femoral Neck Fractures - epidemiology Fundamental and applied biological sciences. Psychology Humans Jaw Diseases - chemically induced Jaw Diseases - epidemiology Male Medical sciences Models, Biological Osteonecrosis - chemically induced Osteonecrosis - epidemiology Osteoporosis - drug therapy Risk Assessment Vertebrates: anatomy and physiology, studies on body, several organs or systems Vertebrates: endocrinology |
| title | Benefits and Risks of Bisphosphonate Therapy for Osteoporosis |
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