Authors: P Eiken P Vestergaard
Publish Date: 2015/10/05
Volume: 27, Issue: 1, Pages: 1-12
Abstract
Alendronate ALN and risedronate RIS are ideal as firstchoice therapy options in the treatment of postmenopausal osteoporosis What to do for patients who do not respond adequately to bisphosphonates has not been conclusively determined but transitioning to other therapies should be considered The aim of this article is to describe potential alternatives for patients switching from ALN or RIS to other therapies for osteoporosis A systematic search of PubMed was conducted to find papers that evaluate the effects of switching therapies on fractures bone mineral density BMD or bone turnover markers Results from 11 studies that prospectively assessed treatment after ALN or RIS in women with postmenopausal osteoporosis were reviewed All studies are of short duration all 24 months or less and assess the topic of transitioning therapy from ALN or RIS None of the studies had the statistical power to assess fracturereduction efficacy Transitioning from ALN to zoledronic acid maintains therapeutic effects for 12 months Switching to strontium ranelate denosumab or teriparatide causes further increases in BMD Specifically transitioning to teriparatide could be used for a limited time for select patients but needs to be followed up with antiresorptive treatment to prevent a loss of the bone gained There are only few studies—of short duration—that assess the topic of transitioning therapy from ALN or RIS although this is a very frequent occurrence in clinical practice This is especially true if the patient has not reached his/her therapy goal Further longterm studies are neededPE is an advisory board member with Amgen MSD and Eli Lilly and at the speakers bureau with Amgen and Eli Lilly PV has received unrestricted grants from MSD and Servier and travel grants from Amgen Eli Lilly Novartis SanofiAventis and Servier
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