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Korean J Med > Volume 87(2); 2014 > Article
The Korean Journal of Medicine 2014;87(2): 151-155.
비스포스포네이트의 치료 기간
김경민1, 이유미2
1서울대학교 의과대학 분당서울대학교병원 내과
2연세대학교 의과대학 내과학교실
Duration of Bisphosphonate Treatment
Kyoung Min Kim1, Yumie Rhee2
11Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
2Department of Internal Medicine, Yonsei University Colleage of Medicine, Seoul, Korea
Corresponding Author: Yumie Rhee ,Tel: +82-2-2228-1973, Fax: +82-2-393-6884, Email: yumie@yuhs.ac
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Large, randomized, controlled trials have demonstrated the efficacy of bisphosphonates (BP) in terms of improving bone mineral density (BMD) and reducing fracture risk. Consequently, bisphosphonates are used widely in the treatment of osteoporosis. Recently, however, several safety issues regarding the long-term use of BP, especially BP-related osteonecrosis of the jaws and atypical fractures, have been noted and have emerged as a limitation of their clinical use. Although the absolute risk is very small, the risks could increase with the long-term use of BP. The anti-fracture efficacy of BP is not sustained after treatment for 5-10 years. Therefore, recommendations suggest that a drug holiday be considered after 5 years of treatment for patients at low risk of fracture. However, as the individual fracture risk varies, the treatment duration should be based on individual clinical risk factors and bone metabolism status. Moreover, recommendations regarding monitoring after discontinuing and reinitiating BP await further studies.
Keywords: Bisphosphonates; Osteoporosis; Safety; Drug holiday
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