bisfosfonianów

Bisfosfoniany, known in English as bisphosphonates, are a class of drugs primarily used to prevent and treat bone disorders characterized by increased bone resorption. These synthetic compounds are structural analogs of pyrophosphate, a natural regulator of bone mineralization, and they inhibit osteoclast-mediated bone resorption by disrupting the bone remodeling process.

Bisphosphonates exert their effects mainly by binding to hydroxyapatite in bone tissue, where they are ingested by osteoclasts during bone resorption. Within the osteoclasts, they interfere with critical biochemical pathways, particularly by inhibiting the enzyme farnesyl pyrophosphate synthase in the mevalonate pathway. This disruption impairs osteoclast function and survival, leading to decreased bone breakdown.

Clinically, bisphosphonates are commonly prescribed for conditions such as osteoporosis, Paget’s disease of bone, multiple myeloma, and bone metastases associated with cancers such as breast and prostate cancer. They have been effective in reducing fractures and skeletal-related events in these patient populations.

Common side effects include gastrointestinal discomfort, hypocalcemia, and in rare cases, osteonecrosis of the jaw. Long-term use has also been associated with atypical femoral fractures.

Bisphosphonates are available in oral forms, such as alendronate and risedronate, and as intravenous formulations, including zoledronic acid. Their use should be carefully monitored by healthcare providers to balance therapeutic benefits with potential adverse effects. Overall, bisphosphonates remain a cornerstone in the management of various metabolic and malignancy-related bone diseases.