Bisphosphonate: An Invaluable Medication or Abandoned Acid?

HoeJeong Chung; Jin Woo Lee; Jae Woong Um; Hoon-Sang Sohn

doi:10.12671/jkfs.2021.34.3.122

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Review Article Bisphosphonate: An Invaluable Medication or Abandoned Acid?: HoeJeong Chung, Jin Woo Lee, Jae Woong Um, Hoon-Sang Sohn; Journal of Musculoskeletal Trauma 2021;34(3):122-130.
DOI: https://doi.org/10.12671/jkfs.2021.34.3.122
Published online: July 31, 2021

Department of Orthopaedic Surgery, Wonju Severance Christian Hospital, Wonju, Korea

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Abstract

Over the last two decades, bisphosphonate has widely been applied in the treatment of osteoporosis. We reviewed the various adverse effects, current trials involving diverse bone metabolic diseases, and the future direction of bisphosphonate. Acute phase reaction, hypocalcemia, ocular inflammation, and gastrointestinal disturbances are the well-known short-term side-effects of bisphosphonate. Long term side-effects include osteonecrosis of the jaws and atypical femur fracture. In the modern clinical setting, bisphosphonate is widely used in treatments for osteoporosis, osteopenia, osteoarthritis, rheumatoid arthritis, and metastatic bone cancer. Further studies are underway for expanding the application as a bone-targeting agent in bone-related diseases. Bisphosphonate remains useful and invaluable as the 1st line medication for osteoporosis. Considering the numerous clinical situations, including time to medication after fracture, duration of drug usage, and individual drug holiday, an optimal and proper use of bisphosphonate needs to be achieved. In the current scenario, bisphosphonate will retain a strong position due to good efficacy and effectiveness for osteoporosis treatment, and the precise ap- plication to various bone diseases. We anticipate a key role of bisphosphonate for future application in the treatment of metabolic bone diseases. Further studies and advancement are highly anticipated, considering the high potential of bisphosphonate for various uses.

Keywords: Bisphosphonate

J Korean Fract Soc. 2021 Jul;34(3):122-130. Korean.
Published online Jul 23, 2021.
https://doi.org/10.12671/jkfs.2021.34.3.122

Review

Bisphosphonate: An Invaluable Medication or Abandoned Acid?

HoeJeong Chung

, M.D., Jin Woo Lee

, M.D., Jae Woong Um

, M.D. and Hoon-Sang Sohn

, M.D., Ph.D.

Author information

Author notes

- Department of Orthopaedic Surgery, Wonju Severance Christian Hospital, Wonju, Korea.
Correspondence to: Hoon-Sang Sohn, M.D., Ph.D. Department of Orthopaedic Surgery, Wonju Severance Christian Hospital, 20 Ilsan-ro, Wonju 26426, Korea. Tel: +82-33-741-0607, Fax: +82-33-741-1365, Email: traumasohn@gmail.com

Received June 30, 2021; Revised July 02, 2021; Accepted July 02, 2021.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Over the last two decades, bisphosphonate has widely been applied in the treatment of osteoporosis. We reviewed the various adverse effects, current trials involving diverse bone metabolic diseases, and the future direction of bisphosphonate. Acute phase reaction, hypocalcemia, ocular inflammation, and gastrointestinal disturbances are the well-known short-term side-effects of bisphosphonate. Long term side-effects include osteonecrosis of the jaws and atypical femur fracture. In the modern clinical setting, bisphosphonate is widely used in treatments for osteoporosis, osteopenia, osteoarthritis, rheumatoid arthritis, and metastatic bone cancer. Further studies are underway for expanding the application as a bone-targeting agent in bone-related diseases. Bisphosphonate remains useful and invaluable as the 1st line medication for osteoporosis. Considering the numerous clinical situations, including time to medication after fracture, duration of drug usage, and individual drug holiday, an optimal and proper use of bisphosphonate needs to be achieved. In the current scenario, bisphosphonate will retain a strong position due to good efficacy and effectiveness for osteoporosis treatment, and the precise application to various bone diseases. We anticipate a key role of bisphosphonate for future application in the treatment of metabolic bone diseases. Further studies and advancement are highly anticipated, considering the high potential of bisphosphonate for various uses.

Keywords

Bisphosphonate

Figures

Fig. 1
Possible pathogenesis of atypical fracture. (A) Normal process for repair of microdamage via targeted remodeling. (B) Factors influencing the accumulation and repair of microdamage that may be related to the pathogenesis of atypical femoral fracture.

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Financial support:None.

Conflict of interests:None.

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