Position Statement: Drug Holiday in Osteoporosis Treatment with Bisphosphonates in South Korea

Overview

Journal J Bone Metab

Date 2015 Dec 30

PMID 26713307

Citations 11

Authors

Seung Hun Lee

Hyun Sik Gong

Tae-Hee Kim

Si Young Park

Jung-Ho Shin

Sun Wook Cho

Dong-Won Byun

Affiliations

Soon will be listed here.

Abstract

Bisphosphonates have been widely used in the treatment of osteoporosis with robust data from many placebo-controlled trials demonstrating its efficacy in fracture risk reduction over 3 to 5 years of treatment. Although bisphosphonates are generally safe and well tolerated, concerns have emerged about the adverse effects related to its long-term use, including osteonecrosis of the jaw and atypical femur fractures. Because bisphosphonates are incorporated into the skeleton and continue to exert an anti-resorptive effect for a period of time after the discontinuation of drugs, the concept of a "drug holiday" has emerged, whereby the risk of adverse effects might be decreased while the patient still benefits from anti-fracture efficacy. As randomized clinical trial evidence is not yet available on who may qualify for a drug holiday, there is considerable controversy regarding the selection of candidates for the drug holiday and monitoring during a drug holiday, both of which should be based on individual assessments of risk and benefit. This statement will provide suggestions for clinicians in South Korea on the identification of possible candidates and monitoring during a bisphosphonate drug holiday.

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