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Ther Adv Musculoskelet Dis. 2013 Jun;5(3):107-11. doi: 10.1177/1759720X13477714.

Bisphosphonate drug holiday: who, when and how long.

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Cincinnati VA Medical Center, University of Cincinnati Bone Health and Osteoporosis Center, Division of Endocrinology/Metabolism, Department of Internal Medicine, 260 Stetson Street, Suite 4200, Cincinnati, OH 45219, USA.


Bisphosphonates have been widely used in the treatment of osteoporosis with robust data from numerous placebo-controlled trials demonstrating efficacy in fracture risk reduction over 3-5 years of treatment. Although bisphosphonates are generally safe and well tolerated, concerns have emerged about adverse effects related to long-term use. For most patients with osteoporosis, the benefits of treatment outweigh the risks. Because these agents accumulate in bone with some persistent antifracture efficacy after therapy is stopped, it is reasonable to consider a 'drug holiday.' There is considerable controversy regarding the optimal duration of therapy and the length of the holiday, both of which should be based on individual assessments of risk and benefit.


bisphosphonates; drug holidays; fractures; osteoporosis

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