Doctors recommend drug holidays from bisphosphonates to enhance bone health

Taking time off from certain osteoporosis drugs may be beneficial to bone health, according to a study conducted at Loyola University Health System. Researchers found that bone density remained stable for three years in patients who took a drug holiday from bisphosphonates, a popular class of osteoporosis drugs that can cause fractures in the thigh bones and tissue decay in the jaw bone.

"These drugs are potentially harmful when taken for long durations, yet little has been known until now about the length of time osteoporosis patients should go without treatment for this debilitating condition," said Pauline Camacho, MD, study investigator and director of the Loyola University Osteoporosis and Metabolic Bone Disease Center. "Our study demonstrated that bones can remain stable for a number of years after these drugs are discontinued."

Doctors recommend that patients take drug holidays from bisphosphonates after four to five years. These drugs continue to stabilize bones and reduce the risk for bone loss after treatment ceases.

The study's goal was to identify the optimal drug holiday length after prolonged use of bisphosphonates based on changes in bone mineral density and bone loss. The study evaluated 139 patients (123 females, 16 males) with osteoporosis and osteopenia, the precursor to the disease. Patients took a bisphosphonate an average of 6.8 years before beginning a drug holiday from 2005 to 2010. Over three years, five fractures occurred, but bone mineral density did not change significantly. However, bone loss did start to increase at six months. The type of bisphosphonate and the duration of treatment did not affect bone mineral density.

"While further research is needed to adequately assess the optimal duration of the drug holiday, we do know that patients can relatively safely discontinue their treatment for at least three years," Dr. Camacho said. "However, patients who fracture during their drug holiday should notify their physician right away so osteoporosis therapy can be resumed. Patients also should continue to see their physician to regularly monitor their bone health."