• Medicina clinica · Oct 2022

    Review

    Aminobisphosphonates: Reconsideration 25 years after their approval for the treatment of osteoporosis.

    • Jesús González Macías and José Manuel Olmos Martínez.
    • Departamento de Medicina y Psiquiatría, Universidad de Cantabria, Santander, Cantabria, España. Electronic address: mirgmj47@gmail.com.
    • Med Clin (Barc). 2022 Oct 14; 159 (7): 336-343.

    AbstractAminobisphosphonates are widely used in the treatment of osteoporosis. They have a high affinity for hydroxyapatite, binding primarily to resorbing surfaces, but also to forming surfaces and to some extent to resting surfaces. They inhibit osteoclasts, thereby decreasing remodelling units. Consequently, they increase bone mass and reduce stress risers. This decreases the risk of fractures. If this decrease is sufficient, they can be temporarily withdrawn (drug holidays), which prevents serious complications (atypical femoral fracture). They probably reduce mortality. Virtually all patients with osteoporosis can benefit from them at some point in the course of their disease (at the beginning of treatment or after the administration of anabolics, selective estrogen receptor modulators or denosumab). If well tolerated orally, alendronate and risedronate are preferable. Otherwise, zoledronate is preferred. Their efficacy vs. cost-safety-convenience ratio makes aminobisphosphonates reference drugs in the field of osteoporosis.Copyright © 2022 The Authors. Published by Elsevier España, S.L.U. All rights reserved.

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