Biophosphates (BP) are the first line drug used to reduce the risk of vertebral, hip, and non-vertebral fractures in postmenopausal women with osteoporosis. For most postmenopausal womens with osteoporosis the benifit of BP outweight the risks. Therefore this study reported the 40% incresed of clinical fractures in womens who took a BP drug holiday.

To estimate the fracture risk among postmenopausal females with osteoporosis following discontinuing BP treatment.

A total of 108 postmenopausal females with osteoporosis who had undergone a “drug holiday” or continued therapy following first-line BP therapy were selected for analysis. The appearance of new clinical fractures at the time of follow-up was also investigated. The associations between BP “drug holiday” and the appearance of clinical fractures while checking for confounding factors were identified applying the Cox proportional hazards models. Log-rank tests and Kaplan-Meier curves were used to analyse the survival without new clinical fractures.

The patients obtained  Risedronate, Ibandronate, Alendronate, and Zoledronic acid. One hundred sixty-six patients showed 6 to 36 months of follow-up. The rates of new clinical fractures at follow-up were 16.1% for “drug holiday” group and 11.9%for another group. After full adjustment, the “drug holiday” patients showed 1.40 hazard ratio of new clinical fractures. 

The risk of recently found clinical fractures was 40% greater among patients who received a Bisphosphonate drug holiday after the first-line BP therapy.