Bisphosphonates Discontinuation linked to higher Verte Fracture Risk among high risk osteoporosis patients: Study

Key Findings

• 12.3% of patients developed fractures post- discontinuation, and 50% were vertebral.

• 10.41% of the high-risk patients had fracture incidence in the first year.

• The moderate- and low-risk patients had a very minimal risk of fracture, with 0.8% and 1.08%, respectively.

• The BMD loss was substantial and was correlated with longer discontinuation periods at the femoral neck and total hip.

• (Procollagen Type I N-Terminal Propeptide) PINP was the most sensitive marker of changes in bone turnover post-discontinuation.

The study suggests that patients with high-risk osteoporosis should not be withdrawn on bisphosphonates since the risk of fractures, especially vertebral fractures, may begin as early as the first year after discontinuation. Hence, individualized treatment decisions will be important to optimize outcomes and prevent complications due to the cessation of treatment.

Reference:

Salmoral, A., Peris, P., López Medina, C., Flórez, H., Barceló, M., Pascual Pastor, M., Ros, I., Grados, D., Aguado, P., García, S., López, L., Gifre, L., Cerdá, D., Aguilar, F. J., Panero, B., Costa, E., Casado, E., Hernández, B., Martínez Ferrer, A., … for the OsteoResSer Working Group of the Spanish Society of Rheumatology. (2024). Bisphosphonate drug holidays in osteoporosis according to fracture risk profile. Osteoporosis International: A Journal Established as Result of Cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. https://doi.org/10.1007/s00198-024-07309-9