Health and adverse events associated with extended oral bisphosphonates among postmenopausal women: a systematic review
Authors' conclusion
Substantial heterogeneity and limited high-quality evidence preclude definitive conclusions regarding extended oBP use in postmenopausal women. While extended treatment may improve bone density and reduce vertebral fractures, it could also increase atypical fractures. Future high-quality studies are required to inform decisions regarding optimal treatment duration.
Study context
- Population
- Postmenopausal women receiving oral bisphosphonates beyond 5 years; interventional and observational studies in English, Medline, EMBASE, CINAHL to 15 March 202411 studies
- Comparison
- Extended oral bisphosphonate therapy beyond 5 years
- Outcome
- Health outcomes (BMD, fracture risk) and adverse effects (atypical fracture, ONJ)
Methodological detailsno meta-analysis (high heterogeneity), PRISMA
- No meta-analysis (high heterogeneity)
- PRISMA
Pooled result
As reported in the abstract
Increased BMD at hip
3/3 studies
Increased BMD at femoral neck
3/3 studies
Increased BMD at lumbar spine
5/5 studies
Reduced clinical vertebral fracture risk
1/6 studies
Safety
Adverse effects of extended oral bisphosphonates (oBP)
- Increased risk of atypical fractures
- 3/3 studies
- Increased incomplete atypical femoral fractures
- 1/1 study
- ONJ assessed or reported
- 0 studies
Original publication
Health and adverse events associated with extended oral bisphosphonates among postmenopausal women: a systematic review. J Clin Endocrinol Metab. Published 10 February 2026. doi:10.
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