Bisphosphonate Drug Holidays in Osteoporosis Patients

Osteoporosis is a disease that is estimated to affect 200 million people worldwide, according to recent statistics from the International Osteoporosis Foundation. Recent research into modern therapies of osteoporosis has persisted, hoping to make treatments safer and more readily accessible for this disease. In fact, oral bisphosphonates are considered the current first-line treatment for osteoporosis, according to the Journal of Clinical Medicine. Here’s what evidence tells us about bisphosphonate drug holidays in patients with osteoporosis.

Maintaining healthy bones is a balance between living an active lifestyle with physical exercise and consuming healthy foods that are high in calcium and Vitamin D. The most common therapies include bisphosphonates such as Alendronate, which are mostly prescribe for post-menopausal women, and antibody therapy for immunity deficient causes of bone disorders, but the use of anabolic therapies and osteoanabolic agents is now also gaining interest. At a cellular level, the healthy bone is a balance between osteoblasts, which produce the necessary precursors to form new bones while producing osteoclasts, which are task with cleaning up old bone materials. A disruption in this balance will lead to unhealthy bone development, which will result in becoming less dense or “porous.”

Bisphosphonates can provide effectiveness after increased exposure for 6 to 12 months. In fact, the three to five-consecutive treatment years before starting a drug holiday are based on results from the FLEX and Horizon trials. While some studies have also reported that patients may begin drug holidays five years before their bisphosphonate treatment, however, the link between an increased risk for fracture and total bisphosphonate exposure still remains uncertain.

Studies led by the University of Pennsylvania have also discovered a new cell type that controls the way the bones develop and maintain their structure. This could lead to the potential discovery of new future therapy that specifically targets the cause of the disease and other bone disorders. According to their findings, the bone marrow adipogenic lineage precursors (MALPs) have a significant role in the process of bone remodeling. Also, a defect in the MALPs process plays a key part in the development of osteoporosis. As such, producing a therapy aimed at this process may be the key to treating bone disorders.

Discovering new therapies is exciting for both the medical community and those seeking treatment for osteoporosis. It also allows future hope for medications that allow patients to return to their ‘normal’ lifestyle without the fear of fractures, and enjoy their overall health and well-being.