Bisphosphonates are agents used to prevent bone damage and are beneficial in the treatment of several diseases that affect the bones.
Some of the uses of bisphosphonates include:
Examples of bisphosphonates that are used to suppress bone turnover in Paget’s disease include etidronate, clodronate, pamidronate, alendronate, risedronate and zoledronate. The two most commonly prescribed agents are alendronate and risedronate.
Cancer involving the bone
Bisphosphonates are very effective in the treatment of secondary cancer, cancer that has spread to the bones from elsewhere in the body. Cancer affecting the bones usually leads to increased bone destruction and high levels of blood calcium. The bones become fragile and prone to fracture, even on minor trauma. Examples of bisphosphonates that have been used for treating secondary cancer of the bone include zoledronate, clodronate, ibandronate, and pamidronate.
Osteoporosis is a condition that renders the bones brittle, fragile and prone to breakage. Osteoporosis is one of the more recent indications for bisphosphonate therapy. Etidronate was the first bisphosphonate approved to treat the condition, followed by alendronate, risedronate, ibandronate and zoledronate. These agents have been shown to increase bone mass and reduce spinal fracture risk by 30% to 70% in postmenopausal women. The long-term use (5–10 years) of bisphosphonates as a treatment for osteoporosis appears to be safe.
Bisphosphonates may also be useful in “brittle bone” disorder or osteogenesis imperfecta. Palmidronate, in particular, has proved to be an effective treatment for this condition.
Reviewed by Sally Robertson, BSc