The American Society for Bone and Mineral Research (ASBMR) has published guidance on managing osteoporosis in patients on long-term bisphosphonate treatment. An ASBMR task force acknowledged a dearth of evidence in this area, and noted that it presents management suggestions based on limited data and clinical experience.

ASBMR relied on 2 trials for evidence: The Fracture Intervention Trial Long-term Extension, and the HORIZON extension.

The task force suggests that reassessment be considered after 5 years of oral bisphosphonate or 3 years of intravenous bisphosphonate therapy. For women at high risk of fracture, consider continuation of treatment for up to 10 years (oral) or 6 years (intravenous), with periodic evaluation. For women not at high fracture risk after 3 to 5 years of treatment, consider a drug holiday of 2 to 3 years.

Owing to the lack of evidence, the task force includes in its statement cases that demonstrate how individualization of management can be achieved.

Citation: Adler R, Fuleihan G, Bauer D, et al. Managing osteoporosis in patients on long-term bisphosphonate treatment: Report of a task force of the American Society for Bone and Mineral Research. [Published online ahead of print January 4, 2016]. J Bone Miner Res. doi:10.1002/jbmr.2708.