The consensus of experts of the russian association for osteoporosis on the long-term treatment of osteoporosis with bisphosphonates

Abstract

   Bisphosphonates are the most commonly used drugs for the treatment of osteoporosis and reducing the risk of fractures, which were introduced into clinical practice more than 30 years ago. The bisphosphonate group includes oral (alendronic acid, risedronic acid, ibandronic acid) and parenteral (zoledronic acid, ibandronic acid) preparations. By now, quite large groups of patients with osteoporosis have been taking bisphosphonates for a long time. This fact raises questions about the preservation of the clinical effect, the development of side effects of drugs against the background of prolonged administration, as well as the possibility of cessation or interruption in their use. The document contains recommendations of the experts of the Russian Association for Osteoporosis on the management of patients with osteoporosis receiving bisphosphonate therapy based on the literature review and discussion. The recommended duration of treatment with oral and parenteral bisphosphonates, methods for monitoring the effectiveness of treatment, as well as signs that should be used when deciding on a discontinuation of the therapy or an increase in its duration are formulated. The criteria of ineffectiveness of treatment requiring its correction are discussed. A separate section is devoted to monitoring the patient during a ‘drug holiday’ in taking bisphosphonates and making a decision on resuming treatment. Recommendations are also given for the control and prevention of possible side effects and increasing persistence to bisphosphonate treatment.