At present, there is very limited knowledge about long-term treatment with bisphosphonates for osteoporosis patients. But over the past years, reports suggestive of long-term adverse reactions have been submitted, e.g. osteonecrosis of the jaw and atypical fractures.
In a new report "Long-term treatment of osteoporosis patients with bisphosphonates", the Danish Medicines Agency has therefore reviewed treatment patterns and evidence of suspected adverse reactions of long-term treatment with bisphosphonates. Please find the report to the right.
Many osteoporosis patients in long-term treatment with bisphosphonates
Today, treatment with bisphosphonates is considered the most well-established treatment for osteoporosis patients, and an increasing number of osteoporosis patients are started on this type of medication.
In Denmark, bisphosphonate therapy for osteoporosis patients is often long-term. 65 per cent of patients remain in treatment after five years, whereas half of them are still in treatment after seven years.
The clinical studies from the authorisation of bisphosphonates have a three to four years' duration, and the presently available knowledge about long-term treatment is still very limited.
Lack of knowledge about long-term adverse reactions
The limited knowledge about the long-term effects of treatment should therefore influence considerations about whether the benefits of treatment outweigh the possible risks. For some patients who have a high risk of fractures, a long treatment period, perhaps even life-long, could be beneficial and needed, whereas long-term treatment might not be appropriate for other patients with a small risk of fractures.
Some studies indicate that pausing the treatment could be essential in order to monitor whether the indication to continue treatment is still present.
Important to report symptoms suggestive of long-term adverse reactions
Until further knowledge is obtained, it is important to stay attentive to and report symptoms suggestive of long-term adverse reactions. Reports from doctors in clinical practice are significant in discovering and obtaining the needed data on new, possible long-term effects.
The full article will be brought in Danish in the monthly journal for general practice in Denmark in January 2012.