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Bisphosphonates are a class of drugs that prevent the loss of bone mass, used to treat osteoporosis and similar diseases. They are the most commonly prescribed drugs used to treat osteoporosis. They are called bisphosphonates because they have two phosphonate () groups. Evidence shows that they reduce the risk of fracture in post-menopausal women with osteoporosis. Bone undergoes constant turnover 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. The uses of bisphosphonates include the prevention and treatment of osteoporosis, Paget's disease of bone, bone metastasis (with or without hypercalcaemia), multiple myeloma, primary hyperparathyroidism, osteogenesis imperfecta, fibrous dysplasia, and other conditions that exhibit bone fragility. ==Medical uses== Most physicians use bisphosphonates to treat osteoporosis, osteitis deformans (Paget's disease of the bone), bone metastasis (with or without hypercalcaemia), multiple myeloma, and other conditions involving fragile, breakable bone. In osteoporosis and Paget's, the most popular first-line bisphosphonate drugs are alendronate (Merck) and risedronate. If these are ineffective or if the patient develops digestive tract problems, intravenous pamidronate (Novartis) may be used. Strontium ranelate (protelos, Servier) or teriparatide (Eli Lilly) are used for refractory disease. The use of strontium ranelate is restricted because of increased risk of venous thromboembolism, pulmonary embolism and serious cardiovascular disorders, including myocardial infarction.〔(【引用サイトリンク】url=http://www.mhra.gov.uk/Safetyinformation/DrugSafetyUpdate/CON392870 )〕 In postmenopausal women, the selective estrogen receptor modulator raloxifene is occasionally administered instead of bisphosphonates. Recent evidence suggests that the use of bisphosphonates would be useful in the treatment of Complex regional pain syndrome, a neuro-immune problem with high MPQ scores, low treatment efficacy and symptoms which can include regional osteoporosis. In 2009 bisphosphonates were hailed as "among the only class of medications that has survived placebo-controlled studies showing statistically significant improvement (in CRPS) with therapy." Other bisphosphonates, including medronate (=H, =H) and oxidronate (=H, =OH), are mixed with radioactive technetium and injected, as a way to image bone and detect bone disease. Bisphosphonates have been used to reduce fracture rates in children with the disease osteogenesis imperfecta and to treat otosclerosis by minimizing bone loss. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「bisphosphonate」の詳細全文を読む スポンサード リンク
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