| Autor: |
Gehrke B; Programa de Pós-graduação em Fisiopatologia Clínica e Experimental (FISCLINEX), Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brasil, barbara_gehrke@yahoo.com.br.; Centro de Pesquisa Clínica Multiusuário (CePeM), Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.; Divisão de Endocrinologia, Departamento de Medicina Interna, Faculdade de Ciências Médicas, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brasil., Alves Coelho MC; Programa de Pós-graduação em Fisiopatologia Clínica e Experimental (FISCLINEX), Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.; Centro de Pesquisa Clínica Multiusuário (CePeM), Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.; Divisão de Endocrinologia, Departamento de Medicina Interna, Faculdade de Ciências Médicas, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brasil., Brasil d'Alva C; Núcleo de Atendimento Multidisciplinar às Doenças Osteometabólicas, Departamento de Medicina Clínica, Universidade Federal do Ceará, Fortaleza, CE, Brasil., Madeira M; Divisão de Endocrinologia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil. |
| Abstrakt: |
Bisphosphonates (BPs) are medications widely used in clinical practice to treat osteoporosis and reduce fragility fractures. Its beneficial effects on bone tissue have been consolidated in the literature for the last decades. They have a high affinity for bone hydroxyapatite crystals, and most bisphosphonates remain on the bone surface for a long period of time. Benefits of long-term use of BPs: Large and important trials (Fracture Intervention Trial Long-term Extension and Health Outcomes and Reduced Incidence with Zoledronic acid Once Yearly-Pivotal Fracture Trial) with extended use of alendronate (up to 10 years) and zoledronate (up to 6 years) evidenced significant gain of bone mineral density (BMD) and vertebral fracture risk reduction. Risks of long-term use of BPs: The extended use of antiresorptive therapy has drawn attention to two extremely rare, although severe, adverse events. That is, atypical femoral fracture and medication-related osteonecrosis of the jaw are more common in patients with high cumulative doses and longer duration of therapy. BPs have demonstrated safety and effectiveness throughout the years and evidenced increased BMD and reduced fracture risks, resulting in reduced morbimortality, and improved quality of life. These benefits overweight the risks of rare adverse events. |
