Abstract
Fracture risk reduction in patients with osteoporosis by nitrogen containing bisphosphonate (N-BP) has been well confirmed in the daily practices. N-BPs suppress bone resorption by inhibiting farnesyl diphosphate synthase in mevalonate pathway, reducing protein-prenylation, consequently disrupting the membrance structure in osteoclasts. A once-yearly infusion of zoledronic acid during 3-year period significantly reduced the risk of vertebral fracture by 70% and that of hip fracture by 41% in patients with postmenopausal osteoporosis at the mean age of 73. The annual infusion within 90 days after surgery was associated with a reduction the rate of new fractures and with improved survival. We may count N-BP as one of essential drugs in the health care for elderlies.
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