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Bone, joint and/or muscle pain has been reported
in some studies using nitrogen-containing drugs.
This phenomenon is poorly understood. A potential
causal association with the bisphosphonate may be
strengthened if pain recurs after cessation and then
recommencement of the drug. Other causes of muscu-
loskeletal pain should be sought in such cases. In OI,
musculoskeletal pain is generally reported as being
improved following bisphosphonate administration.
In summary, over the 40-year period during which
bisphosphonates have been used in clinical practice,
the mechanism of action for both simple and nitrogen-
containing compounds has become clear, although
sources of variation in individual response still requires
further investigation. The additional roles of bisphos-
phonates beyond osteoclastic inhibition also deserve
further study. The targeting of bisphosphonates to bone
means that few significant adverse consequences have
been identified for the vast majority of those treated.
[15]
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References
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[14]
