Who will benefit from antiresorptive treatment (bisphosphonates)?

Bisphosphonates are very effective treatments of postmenopausal osteoporosis. They suppress bone turnover, increase bone mineral density (BMD), and maintain or improve structural and material properties of bone, thereby decreasing the risk of fractures. All patients selected for treatment according to current international guidelines can benefit from bisphosphonate therapy independently of their prevalent rate of bone turnover. Long-term extensions (up to 10 years) of pivotal clinical trials with daily bisphosphonate administration showed sustained efficacy with no evidence of adverse effects on bone metabolism and skeletal fragility. Recent studies focus on the resolution of the effects of bisphosphonates on bone metabolism and fracture risk following cessation of long-term treatment. Such studies may help to formulate treatment recommendations according to the risk of the individual patient.