#1-97E. When to Stop Antiresorptives? A Guide to Discontinuation Strategies (Arthritis & Rheumatology, 2025)

In long-term osteoporosis management, have you ever questioned how, when, and why to discontinue antiresorptive drugs like bisphosphonates or denosumab1? This paper discusses the crucial decision-making process for stopping these widely used agents2. It highlights the key differences between them: bisphosphonates retain their effects long after discontinuation due to skeletal retention, whereas stopping denosumab leads to a rapid rebound in bone turnover and an increased fracture risk1.... The most critical clinical takeaway is that to mitigate the rebound fracture risk after denosumab discontinuation, transitioning to a potent bisphosphonate like zoledronic acid is recommended around the time the next denosumab dose is due5.... This underscores the necessity of individualized treatment plans based on patient risk8. However, it is important to note that this article is an "Expert Perspective" and does not present new data from a specific research study1. For clinicians, this paper is highly valuable as it provides concrete, evidence-informed guidance for a common and critical clinical decision in daily practice910.

Reference: ADAMI, Giovanni and SAAG, Kenneth G. Expert Perspective: How, When, and Why to Potentially Stop Antiresorptive Drugs in Osteoporosis. Arthritis & Rheumatology. 2025, 77(10), pp. 1294-1304. DOI: 10.1002/art.43179

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