Bisphosphonates for treatment of osteoporosis: expected benefits, potential harms, and drug holidays.

Objective: To outline the efficacy and risks of bisphosphonate therapy for the management of osteoporosis and describe which patients might be eligible for bisphosphonate "drug holiday."

Quality Of Evidence: MEDLINE (PubMed, through December 31, 2012) was used to identify relevant publications for inclusion. Most of the evidence cited is level II evidence (non-randomized, cohort, and other comparisons trials).

Differences of vertebral area in serial bone density measurements: a common source of potential error in interpretation of BMD change.

Vertebral projected areas in serial BMD scans should not differ significantly to avoid measurement error due to apparent change in projected bone size. This criterion is rarely achieved in clinical practice. We analyzed 103 consecutive pairs of DXA reports to determine the frequency and magnitude of serial differences in vertebral area.