Sound recommendations based on strong clinical research designs are still lacking for
patients taking oral bisphosphonates. The Task Force strategies outlined below have
remained essentially unchanged from those in the original Position Paper and are based
on clinical experience of clinicians (expert opinion) involved in caring for these patients
and case series.
The risk of developing BRONJ associated with oral bisphosphonates increased when duration of therapy exceeded three years. Although the
current level of evidence is not strong, the Task Force considers these strategies for
patients receiving oral bisphosphonates as a prudent set of guidelines that will not
compromise the long-term management of their osteoporosis. As more data become
available and a better level of evidence is obtained, these strategies will be updated and
modified as necessary.