ABSTRACT
Bisphosphonates are synthetic compounds that have a high affinity for calcium-containing crystals, concentrate preferentially in the skeleton and affect bone surface-related processes. The first bisphosphonate was synthesized in the 19th century, but the relevance of these compounds to clinical medicine was recognized in the 1960s1. They were initially developed as inhibitors of growth and dissolution of calcium crystals, but were subsequently found to inhibit osteoclastmediated bone resorption. Because of this action, bisphosphonates were used initially in the management of conditions characterized by excessive osteoclastic bone resorption, such as Paget’s disease of bone and malignancy-associated hypercalcemia. Increasing understanding of bone physiology and pathology as well as of the pharmacological properties of bisphosphonates led to their application to the treatment of other skeletal disorders, including osteoporosis.
