{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T04:12:19Z","timestamp":1777176739119,"version":"3.51.4"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,2,8]],"date-time":"2016-02-08T00:00:00Z","timestamp":1454889600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Treatment discontinuation after long\u2010term bisphosphonate (<jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>), termed a \u2018drug holiday\u2019, has been proposed to reduce the risk of <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>\u2010associated complications. The duration of treatment cessation remains unclear. Changes in bone mineral density (<jats:styled-content style=\"fixed-case\">BMD<\/jats:styled-content>), bone turnover markers (<jats:styled-content style=\"fixed-case\">BTM<\/jats:styled-content>s) and their relationship with <jats:styled-content style=\"fixed-case\">FRAX<\/jats:styled-content> were assessed to help determine the optimum length of a \u2018drug holiday\u2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis of 134 patients (13M, 121F) aged [mean (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>)] 68\u00b74 (8\u00b72)\u00a0years who discontinued <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>s after treatment for 5\u00b79 (3\u00b70)\u00a0years for osteoporosis was undertaken. <jats:styled-content style=\"fixed-case\">BMD<\/jats:styled-content> at the lumbar spine (<jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content>), total hip (<jats:styled-content style=\"fixed-case\">TH<\/jats:styled-content>), and femoral neck (<jats:styled-content style=\"fixed-case\">FN<\/jats:styled-content>) and biochemical parameters including serum 25 (<jats:styled-content style=\"fixed-case\">OH<\/jats:styled-content>) vitamin D, bone turnover markers (plasma <jats:styled-content style=\"fixed-case\">CTX<\/jats:styled-content>, P1<jats:styled-content style=\"fixed-case\">NP<\/jats:styled-content>) and <jats:styled-content style=\"fixed-case\">FRAX<\/jats:styled-content> scores were determined at discontinuation, 12\u201318\u00a0months and 24\u201330\u00a0months off treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">BMD<\/jats:styled-content> decreased significantly at the <jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content> [% change mean (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>): \u22120\u00b794 (3\u00b76), <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b7008], <jats:styled-content style=\"fixed-case\">TH<\/jats:styled-content> [\u22121\u00b74 (2\u00b74), <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b7001] and <jats:styled-content style=\"fixed-case\">FN<\/jats:styled-content> [\u22121\u00b78 (4\u00b74), <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b7001] after treatment discontinuation for 12\u201318\u00a0months. In the subgroup who remained off treatment for 24\u201330\u00a0months, a progressive decline in <jats:styled-content style=\"fixed-case\">BMD<\/jats:styled-content> was seen at the <jats:styled-content style=\"fixed-case\">TH<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">FN<\/jats:styled-content> with total % decrease of \u22122\u00b752 (3\u00b75) and \u22122\u00b77 (4\u00b776), <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b7001, respectively. <jats:styled-content style=\"fixed-case\">CTX<\/jats:styled-content> and P1<jats:styled-content style=\"fixed-case\">NP<\/jats:styled-content> increased significantly at 12\u201318\u00a0months after discontinuation [% change <jats:styled-content style=\"fixed-case\">CTX<\/jats:styled-content>: 95 (88), <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b7001, P1<jats:styled-content style=\"fixed-case\">NP<\/jats:styled-content>: 88 (73), <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b7001]. <jats:styled-content style=\"fixed-case\">FRAX<\/jats:styled-content> scores were significant predictors of % change in <jats:styled-content style=\"fixed-case\">BMD<\/jats:styled-content> at the <jats:styled-content style=\"fixed-case\">FN<\/jats:styled-content> (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b705), independently of bone turnover and vitamin D status. In summary, our data show that following a \u2018drug holiday\u2019, the use of <jats:styled-content style=\"fixed-case\">DEXA<\/jats:styled-content> scans, <jats:styled-content style=\"fixed-case\">BTM<\/jats:styled-content>s and <jats:styled-content style=\"fixed-case\">FRAX<\/jats:styled-content> may help guide when to resume treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.13012","type":"journal-article","created":{"date-parts":[[2015,12,30]],"date-time":"2015-12-30T11:18:40Z","timestamp":1451474320000},"page":"509-515","source":"Crossref","is-referenced-by-count":20,"title":["Changes in bone mineral density and bone turnover in patients on \u2018drug holiday\u2019 following bisphosphonate therapy: real\u2010life clinic setting"],"prefix":"10.1111","volume":"84","author":[{"given":"J.","family":"Roberts","sequence":"first","affiliation":[{"name":"Department of Chemical Pathology and Metabolic Medicine St Thomas\u2019 Hospital London UK"},{"name":"Metabolic Bone Clinic Department of Rheumatology Guy's Hospital London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Castro","sequence":"additional","affiliation":[{"name":"Department of Chemical Pathology and Metabolic Medicine St Thomas\u2019 Hospital London UK"},{"name":"Metabolic Bone Clinic Department of Rheumatology Guy's Hospital London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.E.B.","family":"Moore","sequence":"additional","affiliation":[{"name":"Osteoporosis Unit Division of Imaging Sciences (Kings College London) Guy's Hospital London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I.","family":"Fogelman","sequence":"additional","affiliation":[{"name":"Metabolic Bone Clinic Department of Rheumatology Guy's Hospital London UK"},{"name":"Osteoporosis Unit Division of Imaging Sciences (Kings College London) Guy's Hospital London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Hampson","sequence":"additional","affiliation":[{"name":"Department of Chemical Pathology and Metabolic Medicine St Thomas\u2019 Hospital London UK"},{"name":"Metabolic Bone Clinic Department of Rheumatology Guy's Hospital London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,2,8]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)07088-2"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.14.1344"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa067312"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.0707onj"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1010650"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.296.24.2927"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.11"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-0412"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-007-0460-7"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.1494"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2005.05.003"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2014.1232"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.1864"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.1582"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2013.05.013"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-130-6-199903160-00002"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.85.4.1492"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-012-2093-8"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001980070088"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-010-1501-1"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2015.07.024"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocd.2011.05.008"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11914-010-0032-1"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-007-0379-z"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/1759720X09359541"}],"container-title":["Clinical Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcen.13012","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cen.13012","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T22:32:04Z","timestamp":1695508324000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cen.13012"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,2,8]]},"references-count":25,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2016,4]]}},"alternative-id":["10.1111\/cen.13012"],"URL":"https:\/\/doi.org\/10.1111\/cen.13012","archive":["Portico"],"relation":{},"ISSN":["0300-0664","1365-2265"],"issn-type":[{"value":"0300-0664","type":"print"},{"value":"1365-2265","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,2,8]]}}}