Bisphosphonates in General Practice: An Audit on the Management of Osteoporosis

摘要

Sir, An estimated 300,000 people aged 50 and over are currently living with osteoporosis in IrelandSUP1/SUP. For decades, bisphosphonates have been used as the drug of choice for the treatment of osteoporosis. Despite their efficacy against the development of fractures in osteoporosis, bisphosphonates have been associated with serious, albeit rare, adverse events. These include osteonecrosis of the jaw, as well as atypical fractures of the subtrochanteric and diaphyseal femurSUP2/SUP. As such, the possibility of a ‘drug holiday’ should be evaluated in all patients on bisphosphonate treatment. The Fracture Risk Assessment (FRAX) Tool incorporates non-Bone Mineral Density (BMD) clinical features into the assessment of a patient’s fracture risk. FRAX scores should be used in combination with DEXA in determining an individual’s appropriateness to remain on bisphosphonates. An algorithm outlining this was developed by the Derbyshire Joint Area Prescribing Committee NHS (DJAPC-NHS)SUP3/SUP. By following this algorithm for all patients on bisphosphonates, bisphosphonate-related adverse events may be avoided.