Bisphosphonates (BPs) are now widely used for the prevention of osteoporotic fracture. The elevation of bone turnover markers (BTM) is an independent risk factor for the bone fracture, and their significant decrease with BPs treatment is considered to reflect BPs' efficacy to "adjust" bone turnover. A large-scale study so far showed that BPs continuously suppress both BTM levels and the incidence of fracture as long as 7 to 10 years, though possible deterioration of bone strength with long-term severe suppression of BTM has been pointed out.
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