Bisphosphonates in the management of osteopenia

• Soanna M. Vílchez R. Faculty of Medicine, University of Zulia

DOI: https://doi.org/10.5281/zenodo.21089571

Keywords: Bisphosphonates, osteopenia, osteoporosis, adverse effects, atypical fractures.

Abstract

Bisphosphonates are synthetic compounds, structurally analogous to endogenous pyrophosphate, whose antiresorptive mechanism is based on the regulation of bone metabolism, particularly calcium and phosphorus. Their efficacy in managing osteopenia and other bone pathologies has been extensively supported by scientific research. However, prolonged administration has been associated with severe adverse effects, such as atypical femoral fractures and cardiovascular disorders. For this review, searches were conducted in specialized databases such as PubMed, Scielo, and Elsevier using the keywords: “Bisphosphonates,” “Osteopenia,” “Osteoporosis,” “adverse effects,” and “atypical fractures.” Studies published between 2023 and 2025 in English and Spanish were selected based on the inclusion criteria of peer-reviewed articles, full-text availability, and direct thematic relevance. Exclusion criteria comprised opinion articles, isolated clinical case reports, and publications lacking methodological validation. Relevant data were synthesized into comparative tables, and bibliometric analysis software VOSviewer was utilized to identify research trends. The findings confirm the effectiveness of bisphosphonates in treating osteopenia and other bone diseases, though prolonged use entails significant risks. It is essential to balance therapeutic benefits with potential adverse effects, considering treatment duration and the individual profile of each patient.

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