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Can bone turnover markers help to define the suitability and duration of bisphosphonate drug holidays?

Statham, Louise, Aspray, Terry and Abdy, Sharon (2020) Can bone turnover markers help to define the suitability and duration of bisphosphonate drug holidays? Drugs in Context.

Item Type: Article


Background: On stopping bisphosphonate treatment, bone resorption may increase before evidence of a decrease in bone density. Offset of bisphosphonate effect may therefore be monitored by measuring C-terminal telopeptide (CTX) following long-term bisphosphonate treatment to inform clinical decisions on drug holiday.
Methods: Retrospective analysis of 158 patients (83% female, mean age 71 years) starting a drug holiday had plasma CTX measured at discontinuation (baseline), n=138 and 4 months and n=136, and 12 months (n=100). Premenopausal mean CTX levels and the least significant change (LSC) detectable were used to define target thresholds for bone turnover.
Results: Following long-term bisphosphonate treatment (69% alendronic acid, 33% risedronate, mean duration 8 years SD 2.7), 32% patients had CTX above target (0.19 μg/L). In those with baseline CTX below threshold, 28% increased CTX to >0.19 μg/L and > LSC (0.06 μg/L) by 4 months (mean CTX increase 0.05 μg/L [95% confidence interval (CI): 0.04–0.06; p<0.0001]) and 53% by 12 months (mean CTX increase 0.09 μg/L [95% CI: 0.07–0.10; p<0.0001]), whilst 47% had no detectable changes in CTX over 12 months.

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Uncontrolled Keywords: bone resorption, osteoporosis, bone remodelling, collagen type 1, risedronate, alendronate.
Depositing User: Louise Statham


Item ID: 12085
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ORCID for Louise Statham: ORCID iD

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Date Deposited: 01 Jun 2020 08:20
Last Modified: 12 Jan 2021 17:03


Author: Louise Statham ORCID iD
Author: Terry Aspray
Author: Sharon Abdy

University Divisions

Faculty of Health Sciences and Wellbeing


Sciences > Health Sciences
Sciences > Pharmacy and Pharmacology

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