Skeletal accumulation of bisphosphonates: Implications for osteoporosis treatment

Research output: Contribution to journalReview articlepeer-review

20 Scopus citations


Background: Bisphosphonates (BPs), the gold-standard pharmacological treatment for osteoporosis, are unique in that they become physically bound to the bone matrix and therefore accumulate over time. This skeletal accumulation has important physiological implications that are not completely understood. Objective: To review concepts related to the biological effects of BP accumulation in the skeleton. Methods: Articles concerning skeletal accumulation of BP treatment were identified. Results/conclusions: Skeletal accumulation of BP, dictated by both chemical and biological factors, is dose-dependent, differs among skeletal sites and likely differs among the various BPs. Bisphosphonate embedded within the skeletal matrix has lasting biological effects, the results of which have both positive and negative implications for bone remodeling. As alternative anti-remodeling agents gain approval for treatment of osteoporosis, the property of skeletal accumulation will likely be unique to BPs and therefore may be the property that determines the future use of this drug class.

Original languageEnglish (US)
Pages (from-to)1371-1378
Number of pages8
JournalExpert Opinion on Drug Metabolism and Toxicology
Issue number11
StatePublished - Nov 1 2008


  • Anti-remodeling agents
  • Bisphosphonates
  • Osteonecrosis of the jaw
  • Osteoporosis treatment
  • Remodeling suppression

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology

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