bisphosphonates for treatment of osteoporosis expected…：治疗骨质疏松症的双磷酸盐类药物预期….pdf

324 Canadian Family Physician Le Médecin de famille canadien |VOL 60: APRIL ? A VRIL 2014 Clinical Review Bisphosphonates for treatment of osteoporosis Expected benefits, potential harms, and drug holidays Jacques P. Brown MD Suzanne Morin MD MSc William Leslie MD Alexandra Papaioannou MD Angela M. Cheung MD PhD h S. Davison PhD David Goltzman MD David Arthur Hanley MD Anthony Hodsman MD Robert Josse MD Algis Jovaisas MD Angela Juby MD Stephanie Kaiser MD Andrew Karaplis MD David Kendler MD Aliya Khan MD Daniel Ngui MD Wojciech Olszynski MD PhD Louis-es Ste-Marie MD Jonathan Adachi MD Abstract Objective To outline the efficacy and risks of bisphosphonate therapy for the management of osteoporosis and describe which patients might be eligible for bisphosphonate “drug holiday.” Quality of evidence MEDLINE (PubMed, through December 31, 2012) was used to identify relevant publications for inclusion. Most of the evidence cited is level II evidence (non-randomized, cohort, and parisons trials). Main message The antifracture efficacy of approved first-line bisphosphonates has been proven in randomized controlled clinical trials. However, with more extensive and prolonged clinical use of bisphosphonates, associations have been reported between their administration and the occurrence of rare, but serious, adverse events. Osteonecrosis of the jaw and atypical s