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Bisphosphonate discontinuation is recommended for women without low hip
BMD after 3-5 years of treatment while treatment continuation is suggested for
women with low hip BMD.
Bisphosphonate discontinuation might be effective for women who do not have low hip BMD following 3–5 years of initial treatment, on the other hand, women who have low hip BMD may benefit from treatment continuation revealed in a study published in Osteoporosis International.
S. Nayak and S. L. Greenspan executed a systematic review and meta-analysis studying the effect of drug holidays or drug discontinuation on BMD and fracture risk. They searched PubMed, Embase, and Cochrane Library databases to find out the controlled clinical trials and cohort studies examining the effect of drug discontinuation vs osteoporosis treatment continuation. A random-effects meta-analysis of hazard ratios of hip and any clinical osteoporotic fracture was performed for individuals who discontinued bisphosphonates compared to the users continuing the drug. Thirteen records describing the results from 8 different studies met the inclusion criteria. As per the FLEX study, a reduced clinical vertebral fracture risk with 10 years of alendronate therapy compared to 5, was found. As per the HORIZON extension studies, there was a reduced risk of morphometric vertebral fracture with 6 years of zoledronic acid therapy compared to 3. The women with low hip BMD T-scores following the initial treatment period profited from continued treatment concerning reduced vertebral fracture risk.
The
meta-analysis of adjusted hazard ratios of hip and any clinical osteoporotic
fracture for women who discontinued bisphosphonates depicted no significant
differences in the risk of hip fracture or any clinical fracture as compared to
persistent users.
Osteoporosis International
A systematic review and meta-analysis of the effect of bisphosphonate drug holidays on bone mineral density and osteoporotic fracture risk
S. Nayak and S. L. Greenspan
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