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Bisphosphonate
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{{Short description|Pharmaceutical drugs for preventing bone loss}} {{Distinguish|Biphosphate (disambiguation){{!}}Biphosphate}} {{Redirect-distinguish|Diphosphonate|Diphosphate}} [[File:Biphosphonate Structural Formulae.png|thumb|200x200px|The general chemical structure of bisphosphonate. The [[Substituent|R-group]]s determine the chemical properties of the drug, and distinguishes individual types of bisphosphonates. This chemical structure affords a high affinity for calcium hydroxyapatite, allowing for rapid and specific skeletal targeting.]] '''Bisphosphonates''' are a class of drugs that prevent the loss of [[bone density]], used to treat [[osteoporosis]] and similar diseases. They are the most commonly prescribed to treat osteoporosis.<ref name="Nat Osteo Soc">{{cite web|last=National Osteoporosis Society|title=Drug Treatment|url=http://www.nos.org.uk/page.aspx?pid=264&srcid=234|publisher=U.K. National Osteoporosis Society|access-date=7 August 2012|archive-url=https://web.archive.org/web/20121106105018/http://www.nos.org.uk/page.aspx?pid=264&srcid=234|archive-date=6 November 2012|url-status=dead}}</ref> Evidence shows that they reduce the risk of fracture in post-menopausal women with osteoporosis.<ref name="Eriksen EF, Díez-Pérez A, Boonen S 126–35">{{cite journal |vauthors=Eriksen EF, Díez-Pérez A, Boonen S |title=Update on long-term treatment with bisphosphonates for postmenopausal osteoporosis: a systematic review |journal=Bone |volume=58 |pages=126–35 | date=January 2014|pmid=24120384 |doi=10.1016/j.bone.2013.09.023}}</ref><ref name="Serrano AJ, Begoña L, Anitua E, Cobos R, Orive G 1005–14">{{cite journal |vauthors=Serrano AJ, Begoña L, Anitua E, Cobos R, Orive G |title=Systematic review and meta-analysis of the efficacy and safety of alendronate and zoledronate for the treatment of postmenopausal osteoporosis |journal=Gynecol. Endocrinol. |volume=29 |issue=12 |pages=1005–14 | date=December 2013|pmid=24063695 |doi=10.3109/09513590.2013.813468 |s2cid=20163452 }}</ref><ref name="gauthier">{{cite journal|last1=Gauthier|first1=K|last2=Bai|first2=A|last3=Perras|first3=C|last4=Cunningham|first4=J|last5=Ahuja|first5=T|last6=Richter|first6=T|last7=Kovacs|first7=C|title=Denosumab, Raloxifene, and Zoledronic Acid for the Treatment of Postmenopausal Osteoporosis: Clinical Effectiveness and Harms|journal=Rapid Response Report: Systematic Review|date=February 2012|pmid=24278999}}</ref><ref name=AACE2010/><ref name="Kanis JA, McCloskey EV, Johansson H, Cooper C, Rizzoli R, Reginster JY 23–57">{{cite journal |vauthors=Kanis JA, McCloskey EV, Johansson H, Cooper C, Rizzoli R, Reginster JY |title=European guidance for the diagnosis and management of osteoporosis in postmenopausal women |journal=Osteoporos Int |volume=24 |issue=1 |pages=23–57 | date=January 2013|pmid=23079689 |pmc=3587294 |doi=10.1007/s00198-012-2074-y }}</ref> [[Bone tissue]] undergoes constant [[bone remodeling|remodeling]] and is kept in balance ([[homeostasis]]) by [[osteoblasts]] creating bone and [[osteoclasts]] destroying bone. Bisphosphonates inhibit the digestion of bone by encouraging osteoclasts to undergo [[apoptosis]], or cell death, thereby slowing bone loss.<ref>{{cite journal |vauthors=Weinstein RS, [[Paula Roberson|Roberson PK]], Manolagas SC |title=Giant osteoclast formation and long-term oral bisphosphonate therapy |journal=N. Engl. J. Med. |volume=360 |issue=1 |pages=53–62 |date=January 2009 |pmid=19118304 |pmc=2866022 |doi=10.1056/NEJMoa0802633}}</ref> The uses of bisphosphonates include the prevention and treatment of osteoporosis, [[Paget's disease of bone]], [[bone metastasis]] (with or without [[hypercalcemia]]), [[multiple myeloma]], [[primary hyperparathyroidism]], [[osteogenesis imperfecta]], [[fibrous dysplasia]], and other conditions that exhibit bone fragility.
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