Bisphosphonates - Clinical applications in osteoporosis

Bisphosphonates are effective treatments for the prevention and treatment of osteoporosis. In particular, alendronate and risedronate increase bone mineral density and reduce the spinal fracture rate to approximately 50% of that in controls, within one year. A less potent, 'first generation' bisphosphonate, etidronate, has also shown anti-fracture efficacy. Alendronate also reduces fracture rates at the hip and other non-vertebral sites in osteoporotic postmenopausal women. Pamidronate is available for intravenous therapy and ibandronate and zoledronate may also become available for injection. Current research studies are examining new compounds, treatment regimens and the combination of bisphosphonates with other drugs such as oestrogen, which currently remains the first-line therapy for the prevention and treatment of osteoporosis in women.