Bisphosphonate

The general chemical structure of bisphosphonate. The R-groups determine the chemical properties of the drug, and distinguishes individual types of bisphosphonates. This chemical structure affords a high affinity for calcium hydroxyapatite, allowing for rapid and specific skeletal targeting.

Bisphosphonates are a class of drugs that prevent the loss of bone density, used to treat osteoporosis and similar diseases. They are the most commonly prescribed drugs used to treat osteoporosis.[1] They are called bisphosphonates because they have two phosphonate (PO(OH)
2
) groups. They are thus also called diphosphonates (bis- or di- + phosphonate).

Evidence shows that they reduce the risk of fracture in post-menopausal women with osteoporosis.[2][3][4][5][6]

Bone tissue undergoes constant remodeling and is kept in balance (homeostasis) by osteoblasts creating bone and osteoclasts destroying bone. Bisphosphonates inhibit the digestion of bone by encouraging osteoclasts to undergo apoptosis, or cell death, thereby slowing bone loss.[7]

The uses of bisphosphonates include the prevention and treatment of osteoporosis, Paget's disease of bone, bone metastasis (with or without hypercalcemia), multiple myeloma, primary hyperparathyroidism, osteogenesis imperfecta, fibrous dysplasia, and other conditions that exhibit bone fragility.

  1. ^ National Osteoporosis Society. "Drug Treatment". U.K. National Osteoporosis Society. Archived from the original on 6 November 2012. Retrieved 7 August 2012.
  2. ^ Eriksen EF, Díez-Pérez A, Boonen S (January 2014). "Update on long-term treatment with bisphosphonates for postmenopausal osteoporosis: a systematic review". Bone. 58: 126–35. doi:10.1016/j.bone.2013.09.023. PMID 24120384.
  3. ^ Serrano AJ, Begoña L, Anitua E, Cobos R, Orive G (December 2013). "Systematic review and meta-analysis of the efficacy and safety of alendronate and zoledronate for the treatment of postmenopausal osteoporosis". Gynecol. Endocrinol. 29 (12): 1005–14. doi:10.3109/09513590.2013.813468. PMID 24063695. S2CID 20163452.
  4. ^ Gauthier, K; Bai, A; Perras, C; Cunningham, J; Ahuja, T; Richter, T; Kovacs, C (February 2012). "Denosumab, Raloxifene, and Zoledronic Acid for the Treatment of Postmenopausal Osteoporosis: Clinical Effectiveness and Harms". Rapid Response Report: Systematic Review. PMID 24278999.
  5. ^ Cite error: The named reference AACE2010 was invoked but never defined (see the help page).
  6. ^ Kanis JA, McCloskey EV, Johansson H, Cooper C, Rizzoli R, Reginster JY (January 2013). "European guidance for the diagnosis and management of osteoporosis in postmenopausal women". Osteoporos Int. 24 (1): 23–57. doi:10.1007/s00198-012-2074-y. PMC 3587294. PMID 23079689.
  7. ^ Weinstein RS, Roberson PK, Manolagas SC (January 2009). "Giant osteoclast formation and long-term oral bisphosphonate therapy". N. Engl. J. Med. 360 (1): 53–62. doi:10.1056/NEJMoa0802633. PMC 2866022. PMID 19118304.