Intermittent long-term administration of intravenous bisphosphonates for treatment of osteoporosis

Abstract

Bisphosphonates (BPs) are prescribed most frequently in an oral formulation. However, they have very limited bioavailability, and less than 1% of BPs administered orally are absorbed. In addition, poor adherence to oral BPs has been shown to be associated with suboptimal fracture reduction and prevention. Therefore, intravenous BP regimens have been developed to address this issue. In Japan, intermittent intravenous administration of alendronate and ibandronate on a monthly basis is currently available, and intravenous zoledronate on a yearly basis is expected to be available in the near future. Data have shown that intravenous BPs are noninferior to oral BPs in preventing osteoporotic fractures. Furthermore, intravenous BP administration is particularly advantageous in patients who do not tolerate or adhere to oral BPs, including those with gastrointestinal pathology, polypharmacy, or the inability to remain upright.