The role of bisphosphonates in the prevention and treatment of osteoporosis.

The first-generation biphosphonate etidronate is used only experimentally in osteoporosis prevention. Its effects in treating osteoporosis have been studied only in subjects who already have vertebral crush fractures. No reduction in the incidence of fractures in this population as a whole has been established. The suggestion of a more pronounced beneficial effect seen in severely osteoporotic patients treated with bisphosphonates for two years that seems to emerge from a posteriori analysis must be confirmed. The long-term safety of this therapy is currently under study. Subsequent generations of bisphosphonates are still experimental, whether for prevention or treatment.