“Bisphosphonate holiday” is recommended in postmenopausal women with osteoporosis who are found to have low-to-moderate risk of fractures after taking bisphosphonates for 3 to 5 years.
|
DRUG THERAPY |
REASSESS FRACTURE RISK IN |
DRUG HOLIDAY/ CONTINUE THERAPY |
REASSESS FRACTURE RISK DURING DRUG HOLIDAY |
RESTARTING THERAPY AFTER DRUG HOLIDAY |
|
Oral Bisphosphonate |
5yrs |
Low-moderate risk: Drug Holiday |
2-4yrs |
High risk/ bone loss: Restart therapy |
|
IV Bisphosphonate |
3yrs |
High risk: Continue/switch to another therapy |
|
|
|
Denosumab* |
5-10yrs |
Low-moderate risk: Consider giving bisphosphonate then stopping for drug Holiday
High risk: Continue/switch to another therapy |
1-3yrs |
High risk/ fracture/ bone loss: Restart therapy
|
|
|
|
*Drug Holiday is not recommended with Denosumab.
Reference:
Shoback D, et al. Pharmacological Management of Osteoporosis in Postmenopausal Women: An Endocrine Society Guideline Update. J Clin Endocrinol Metab. 2020 Mar 1;105(3).