Bone Mineral Density Response to Long-Term Bisphosphonate Treatment and Discontinuation in a Real-World Clinical Service
Authors' conclusion
BMD response at FN is suboptimal in patients on oBP and is much less common than LS response. FN responders tend to lose the accumulated bone quickly off-treatment, though BMD remains above pretreatment levels. These observations suggest that new approaches may be needed to optimize osteoporosis management in real-world patients.
Study context
- Population
- Postmenopausal women on oral bisphosphonate (oBP) for ≥3 years, real-world metabolic clinic, assessed at initiation, discontinuation and 1 to 2 years post discontinuation
- Participants
- 213 women
- Exposure
- Femoral neck (FN) responders vs non-responders to oBP, after discontinuation
- Outcome
- Change in BMD following oBP discontinuation by FN response (loss of BMD ≥LSC at FN)
- Follow-up
- 1 to 2 years post discontinuation
Methodological detailsreal-world metabolic clinic
- Real-world metabolic clinic
Main finding
As reported in the abstract
Lost BMD ≥LSC at FN off-treatment
P < 0.001
Observational data: associations, not effects.
Further findings
g/cm²
| Outcome | Non-responders | P value |
|---|---|---|
| Pretreatment baseline FN BMDResponders vs Non-responders · lower in responders | 0.62 | P = 0.003 |
| Pretreatment baseline LS BMDResponders vs Non-responders · lower in responders | 0.79 | P = 0.044 |
- Pretreatment baseline FN bone mineral density (BMD): Responders 0.58 g/cm²
- Pretreatment baseline lumbar spine (LS) BMD: Responders 0.76 g/cm²
Increase ≥least significant change (LSC) on treatment, FN vs LS
- Increase ≥LSC at FN
- 32.1%
- Increase ≥LSC at LS
- 57.1%
- FN vs LS
- P < 0.0001
Original publication
Bone Mineral Density Response to Long-Term Bisphosphonate Treatment and Discontinuation in a Real-World Clinical Service. Endocr Pract. Published 4 May 2023. doi:10.
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