ReviewDrugs2021
Bone Mineral Density Loss and Fracture Risk After Discontinuation of Anti-osteoporotic Drug Treatment: A Narrative Review.
Review in Drugs, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 4 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Romosozumab adverse event profile: a pharmacovigilance analysis based on the FDA Adverse Event Reporting System (FAERS) from 2019 to 2023.Aging clinical and experimental research · 2025Pooled it
- Clinical Practice Guideline: The Diagnosis and Treatment of Osteoporosis.Deutsches Arzteblatt international · 2025Guideline
- Is withdrawal of antiresorptive agents necessary before and after tooth extraction? A systematic review.Clinical oral investigations · 2023Pooled it
- Clinical efficacy of denosumab, teriparatide, and oral bisphosphonates in the prevention of glucocorticoid-induced osteoporosis: a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2023Pooled it
- Article title efficacy and safety of romosozumab in postmenopausal women with osteoporosis previously treated with antiresorptive drugs: a prospective observational study and literature review.Frontiers in global women's health · 2026Trial
- Restoring skeletal remodeling in antiresorptive-treated patients: clinical outcomes of teriparatide in medication-related osteonecrosis of the jaw.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Review
- Discontinuing Long-Term Denosumab in Treating Fragile Bone: Why, for Whom, and How?Clinical pharmacology and therapeutics · 2026Review
- Postoperative osteoporosis therapy and risk of re-fracture in elderly patients with hip fractures: a multicenter retrospective cohort study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- Modeling rebound bone loss following denosumab discontinuation and sequential zoledronate therapy in TgRANKL osteoporotic mice.Frontiers in endocrinology · 2026Article
- Comparative outcomes of denosumab and zoledronic acid discontinuation in hip fracture surgery: a nationwide database study.Archives of osteoporosis · 2025Article
- METTL9 mediated N1-Histidine methylation of SLC39A7 confers ferroptosis resistance and inhibits adipogenic differentiation in mesenchymal stem cells.Molecular medicine (Cambridge, Mass.) · 2025Article
- MTHFD2 promotes osteoclastogenesis and bone loss in rheumatoid arthritis by enhancing CKMT1-mediated oxidative phosphorylation.BMC medicine · 2025Article
- Therapeutic potential of natural polymer-based transdermal drug delivery system for musculoskeletal disorders.Biomaterials translational · 2025Article
- Qing'e Pills Ameliorates Osteoporosis by Regulating Gut Microbiota and Th17/Treg Balance in Ovariectomized Rats.Journal of inflammation research · 2025Article
- Immunotherapies for Aging and Age-Related Diseases: Advances, Pitfalls, and Prospects.Research (Washington, D.C.) · 2025Review
- LPL-RH suppresses bone loss in ovariectomised rat models.BMC microbiology · 2024Article
- Carbonate Apatite Honeycomb Scaffold-Based Drug Delivery System for Repairing Osteoporotic Bone Defects.ACS applied materials & interfaces · 2024Article
- Bones and guts - Why the microbiome matters.Journal of bone oncology · 2024Article
- Cost-consequence analysis of continuous denosumab therapy for osteoporosis treatment in South Korea.BMC musculoskeletal disorders · 2024Article
- The sequential antifracturative treatment: a meta-analysis of randomized clinical trials.Therapeutic advances in musculoskeletal disease · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The number of patients on long-term anti-osteoporotic drug therapy is rising. Unfortunately, there are few data to guide decisions about duration of pharmacologic therapy for osteoporosis. Many practitioners discontinue therapy after a period of 5 years because of the risk of rare but severe side effects that may occur in long-term users. The objective of this narrative review was to describe the effects of discontinuation of anti-osteoporotic drugs and to investigate what is not yet known on this topic. For each anti-osteoporotic agent, PubMed was searched for evidence from randomized clinical trials in patients with osteoporosis on osteoporotic drugs lasting ≥ 3 years, followed by ≥ 1 year of follow-up after discontinuation of therapy and reported at least one item of the following: changes in bone mineral density, bone turnover markers and/or the risk of vertebral and/or nonvertebral fractures after discontinuation of therapy. The% change in bone mineral density (BMD) after 1 year of discontinuation of therapy is - 0.4% or less at the hip and femoral neck in both alendronate- and zoledronic acid-treated patients. In the other reported agents (risedronate, ibandronate, raloxifene, teriparatide, denosumab and romosozumab) this percentage of bone loss at the femoral neck and total hip was at least 1%, with the largest decrease in BMD after discontinuation of denosumab and romosozumab. In all studies reporting bone turnover markers, a substantial rapid rise in these markers was observed after discontinuation of therapy, with a large rebound increase to far above baseline levels in the denosumab-treated patients. There were few data on fracture risk after discontinuation of therapy; data showed that discontinuing alendronate, zoledronic acid and especially denosumab significantly increases the risk of vertebral fractures. In conclusion, osteoporosis should be considered more as a chronic condition. Therefore, in modern fracture risk management, continuous monitoring and treatment is required, as is the case with other chronic diseases, to sustain the benefits of therapy, especially in denosumab- and romosozumab-treated patients. The exception is alendronate and zoledronic acid, in these patients a discontinuation of drug therapy of 1 year or more might be acceptable.
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