Alternative Indications for Bisphosphonate Therapy
Bisphosphonates are currently used in the treatment of osteoporosis (postmenopausal and steroid-induced), hypercalcemia of malignancy, Paget's disease of bone, multiple myeloma, and skeletally related events associated with metastatic bone disease in breast, prostate, lung, and other cancers. There are, however, numerous other conditions where a decrease in bone remodeling by bisphosphonates might aid in disease management. The focus of this review will be to discuss a select group of conditions for which bisphosphonate therapy may be efficacious. In this review we present several cases where bisphosphonates have been used as a primary or adjunctive treatment for giant cell lesions of the jaws. Use of bisphosphonate therapy for giant cell tumors of the appendicular skeleton, pediatric osteogenesis imperfecta, fibrous dysplasia, Gaucher's disease, and osteomyelitis will be discussed. Finally, we will review previous in vivo studies on the use of bisphosphonates to augment integration and to treat osteolysis surrounding failing orthopedic implants.
⁎Associate Professor, Division of Oral and Maxillofacial Surgery, University of Connecticut Health Center, School of Dental Medicine, Farmington, CT. New York Presbyterian Hospital, New York, NY
†George Gutmann Professor of Clinical Craniofacial Surgery and Chairman, Division of Oral Surgery, Columbia University College of Dental Medicine, New York, NY
‡Clinical Professor of Pediatrics–Endocrinology, Medical Director, Comprehensive Adolescent Bariatric Surgery Program, Morgan Stanley Children's Hospital, Columbia University Medical Center, New York, NY
§Madeline C. Stabile Professor of Clinical Medicine, Director, Stabile Osteoporosis Center, Columbia University Medical Center, New York, NY
Address correspondence and reprint requests to Dr Landesberg: Division of Oral and Maxillofacial Surgery, University of Connecticut Health Center, 263 Farmington Ave, L-7056, Farmington, CT 06032
This article discusses off-label usage for all of the drugs that are listed. Dr Landesberg has received honoraria from Novartis Pharmaceutical Corporation. Dr Fennoy states no financial arrangements or affiliations with a corporate organization or a manufacturer of products discussed in this article. Dr Siris has received honoraria and paid consulting fees from Novartis, Procter and Gamble, and Sanofi-Aventis.
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