Anti-resorptive therapies with bisphosphonates, calcitonins, hormonal treatment, or raloxifene have been used to reduce the risk of osteoporotic vertebral, hip, and other non-vertebral fractures; to maintain or improve bone mass; and to suppress excessive bone turnover.
Bisphosphonates are analogues of pyrophosphate and exhibit marked effects on bone metabolism. The bisphosphonates characteristic phosphorous, carbon and phosphorous bond (P-C-P) renders the class resistant to hydrolysis by phosphatases and enables these molecules to bind tightly to calcified bone matrix. They are very effective inhibitors of osteoclastic bone resorption and have been used clinically in Pagets disease of bone, osteoporosis, and hypercalcemia of malignancy and bone metastases. Zoledronic acid is a representative of a third generation bisphosphonate and is the most potent bisphosphonate in development. Zoledronic acid is about two to three orders of magnitude more potent than pamidronate, and about an order of magnitude more potent than alendronate, risedronate and ibandronate.
Last date updated on November, 2020