Is Long-Term Bisphosphonate Therapy Safe?

In a case series, long-term alendronate use was associated with reduced rates of bone formation and inadequate fracture healing.

Bisphosphonates (alendronate [Fosamax] and others) inhibit bone resorption and reduce the incidence of fractures in osteoporotic patients during several years of use. However, these drugs theoretically might weaken bone in the longer term (e.g., by inhibiting normal repair of bone "microdamage" that occurs in daily life).

These researchers evaluated nine patients who sustained nontraumatic nonspinal fractures (e.g., of the femur or pelvis) after 3 to 8 years of alendronate therapy. Three patients also used estrogen, and two took glucocorticoids. Bone biopsies with labeling studies revealed severe reductions in bone formation rates in all patients compared with previously published rates in healthy postmenopausal women. Eight to 12 months aft…

Reviewing Author

Allan S. Brett, MD