Concept of drug-holiday in bisphosphonate therapy for osteoporosis in postmenopausal women: Are we ready to recommend?
Bishnu Prasad Das
Bisphosphonates (BP) are considered one of the important treatment options for postmenopausal osteoporosis. Subtrochanteric and diaphyseal fractures are common with the long term use of BP and this particular issue has given rise to mainly two aspects of this mode of treatment, i.e., how long one can continue with BP and potential advantages or is there any role of BP drug free days. BP accumulates in bone with some long lasting protective effects after therapy is discontinued endorses this concept of giving a drug holiday in between. Theoretically speaking, a drug free period is an option to be considered to reduce the risks of BP, continuing the protective action against osteoporosis but the level of evidence and data supporting this concept of drug holidays is weak. Hence no specific recommendations are available at present for BP drug free days in currently available treatment guidelines on postmenopausal osteoporosis. Therefore more research in this aspect in future probably would throw light in this subject.