[Use of bisphosphates in treatment of primary and secondary osteoporosis].

Bisphosphonates are chemically stable and not metabolized. They express antiresorptive properties on the bone by inhibiting osteoclastic activity. The potency of antiresorptive activity and inhibition of bone mineralisation depend on chemical structure of different bisphosphonates. Etidronate is so far the best known drug used in therapy of postmenopausal osteoporosis. This is shown through increased bone density of the spine and femoral neck with simultaneously decreased risk of subsequent vertebral fractures. Other bisphosphonates (clodronate, pamidronate, tiludronate, alendronate, risedronate) are undergoing clinical trials, with so far, promising results regarding their clinical efficacy and safety of it's use. Etidronate has been investigated as a drug to prevent corticosteroid induced osteoporosis. Further studies are required to long-term beneficial effects of bisphosphonates on bone metabolism and safety of their prolonged use.