Osteoporosis International

, Volume 25, Issue 6, pp 1659–1666 | Cite as

How long should we treat?

Review

Abstract

Osteoporosis is a chronic disease, for which effective drugs are available. These drugs have reduced the risk of osteoporosis-related fractures in robust trials of 3–5 years duration. There is no evidence of anti-fracture efficacy for treatments of longer duration. The consequences of stopping treatments are very different for the different molecules. Bisphosphonates can be safely discontinued after 3–5 years of treatment if there was optimal adherence and if patients are no longer osteoporotic. This discontinuation cannot be applied in patients with recent fractures or for other treatments. Safety of prolonged treatment is a huge concern which must be managed appropriately. The decision of a prolonged treatment is driven by the underlying risk of fracture. This risk must be assessed regularly in order to share with the patient the benefit-risk ratio of prolonged treatment.

Keywords

Atypical fractures Benefit-risk ratio Bisphosphonates Fractures Long-term treatments Osteoporosis Osteonecrosis of the jaw Stopping treatment 

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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2013

Authors and Affiliations

  1. 1.Department of Rheumatology, Cochin HospitalParis-Descartes UniversityParisFrance

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