Non-antiosteoporotic effects of bisphosphonates: latest studies and prospects

Bisphosphonates, traditionally used to treat osteoporosis, demonstrate a wide range of pleiotropic effects that go beyond their antiresorptive action on bone tissue. This systematic review analyzes current scientific data on the non-antiosteoporotic effects of bisphosphonates obtained in studies from 2015 to 2024. It has been established that bisphosphonates have a pronounced analgesic effect, especially effective in pain syndrome caused by bone metastases. Antitumor effects include oncoprotective action and direct effects on tumor cells through various molecular mechanisms. Cardiovascular effects are manifested in cardioprotective action and influence on vascular calcification processes. The effectiveness of the drugs in joint diseases, including osteoarthritis, has been shown, although data on the effectiveness in aseptic necrosis of the femoral head remain contradictory. Promising areas include use in orthopedic surgery for the prevention of aseptic instability of endoprostheses and the development of conjugates with antibacterial drugs for the treatment of osteomyelitis. Innovative approaches include the use of bisphosphonates for targeted delivery of neurotrophic factors in sensorineural hearing loss. The uniqueness of this review lies in the comprehensive analysis of the entire spectrum of non-antiosteoporotic effects with an emphasis on the latest developments and a critical assessment of the prospects for clinical implementation, taking into account the benefit-risk ratio.

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