Bisphosphonates: Issues of Long-Term Therapy and Evidence of Efficacy in Real Clinical Practice

I.Yu. Holovach

Abstract


Osteoporosis is a disease of great social importance. Its treatment is a complicated problem and is associated with low compliance of patients and a risk for adverse reactions. First-line drugs are bisphosphonates, which have been used in the clinical practice for over 15 years. During this period, there were accumulated the data on adverse events, the incidence of which was very low, or which were not detected at all during the studies on the efficacy and safety of bisphosphonates. Today, it is raised the question about which categories of patients should use bisphosphonate therapy, for how long the drugs of this group needed to be administered, is it possible to stop taking bisphosphonates for a time without increasing the risk of fractures. An algorithm for a long-term treatment of osteoporosis using bisphosphonates and principles of monitoring the effectiveness of therapy are presented. The article describes two clinical cases of ibandronic acid application for the prevention and treatment of postmenopausal osteoporosis with a good clinical effect. The data on changes in bone mineral density during the observation from 12 to 27 months, as well as the risk of fractures by FRAX system are provided. Clinical experience shows that the use of Bonviva in the combination treatment of postmenopausal osteoporosis contributes not only the progressive increase in bone mineral density at the lumbar spine and proximal femur, but also reduces the risk of vertebral fractures.


Keywords


osteoporosis; bisphosphonates; treatment duration; drug holidays; efficiency; ibandronate; clinical cases

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DOI: https://doi.org/10.22141/1608-1706.4.17.2016.77486

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