Long-term tolerability of the bisphosphonates in postmenopausal osteoporosis: a comparative review.

摘要: Osteoporosis in postmenopausal women is a growing health concern for society. Bisphosphonates have become the mainstay of prevention and treatment with mounting evidence their efficacy over past two decades. This review article examines use etidronate, alendronate risedronate. The pivotal trials are reviewed long-term tolerability, regarding histological safety gastrointestinal tolerance. Etidronate, risedronate also been examined meta-analyses, which methodologically sound trials. Length treatment, adverse events medication discontinuation patients lost to follow-up were evaluated. Etidronate recent meta-analysis support safe clinical cyclical etidronate no signs osteomalacia or other skeletal pathology 2 3 years. In addition increased bone mineral density (BMD) vertebral fracture risk reduction, tolerated well up 4 years randomised studies. Non-randomised data has shown 7 biopsy data. Alendronate studies demonstrated similar overall event rates, study rates loss between placebo arms, consistent improvements BMD, non-vertebral reductions Histological Longer-term therapy non-randomised showed placebo. Risedronate profiles as Rates due groups. Each these bisphosphonates comparable years, most rigourous carried out Long-term comparative awaited.