Risks and Benefits of Bisphosphonates
I have written before about the increasing use of bisphosphonates (bone-strengthening drugs) in both adjuvant treatment and the care of women with metastatic disease. As more studies have been completed, there is even more evidence about their value, but also findings of some risks and possible adverse side-effects. Like everything else in life, this becomes a matter of balance and making careful individual decisions.
This is a quote from an editorial in the Journal of Clinical Oncology (JCO) and then a link if you want to read more:
Randomized trials suggest that adjuvant bisphosphonates in early-stage breast cancer may prevent recurrence, andintriguing recent population-based studies hint that this class of drugsmay reduce the incidence of breast cancer in postmenopausalwomen.4-9 Both oral and intravenous bisphosphonates are highlyeffective and commonly used in the prevention and treatment ofosteoporosis, including the treatment of bone loss associated withcancer treatment. The potential clinical indications for bisphosphonatescontinue to expand, making it increasingly important to understandthe risks of these drugs as well as the benefits.
Bisphosphonates are generally well tolerated; a relatively low risk
of serious adverse effects has been reported in clinical trials. The
adverse effect profile of bisphosphonates is still not fully clear, however,
and several safety concerns have emerged in postmarketing
follow-up. The intravenous bisphosphonates are associated with renal
toxicity, electrolyte imbalances, and first-infusion acute phase reactions
typified by fever and flu-like symptoms. GI adverse effects, common
with oral formulations, are generally avoided when these agents
are given intravenously. Examples of rare but serious complications of
bisphosphonates that have come to light after drug approval include
ocular inflammation and osteonecrosis of the jaw.