دانلود مقاله : Bisphosphonate Therapy for Osteoporosis: Benefits, Risks, and Drug Holiday 2013
دانلود مقاله :
Bisphosphonate Therapy for Osteoporosis: Benefits, Risks, and Drug Holiday 2013
نویسندگان :
Michael McClung, MD,a Steven T. Harris, MD,b Paul D. Miller, MD,c Douglas C. Bauer, MD,b K. Shawn Davison, PhD,d Larry Dian, MB, BCH,e David A. Hanley, MD,f David L. Kendler, MD,g Chui Kin Yuen, MD,h E. Michael Lewiecki, MD
فرمت: pdf
چکیده :
The amino-bisphosphonates are first-line therapy for the treatment of most patients with osteoporosis, with
proven efficacy to reduce fracture risk at the spine, hip, and other nonvertebral skeletal sites. Further,
bisphosphonates have been associated with a significant decrease in morbidity and increase in survival.
Following the use of bisphosphonates in millions of patients in clinical practice, some unexpected possible
adverse effects have been reported, including osteonecrosis of the jaw, atypical femur fractures, atrial fibrillation,
and esophageal cancer. Because bisphosphonates are incorporated into the skeleton and continue to exert
an antiresorptive effect for a period of time after dosing is discontinued, the concept of a drug holiday has
emerged, whereby the risk of adverse effects might be decreased while the patient still benefits from antifracture
efficacy. Patients receiving bisphosphonates who are not at high risk for fracture are potential candidates for a
drug holiday, while for those with bone mineral density in the osteoporosis range or previous history of fragility
fracture, the benefits of continuing therapy probably far outweigh the risk of harm.
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