The pharmacology of bisphosphonates and new insights into their mechanisms of action

R G G Russell, M J Rogers, J C Frith, S P Luckman, Fraser Coxon, H L Benford, P I Croucher, C Shipman, H A Fleisch

Research output: Contribution to journalLiterature review

254 Citations (Scopus)


Bisphosphonates are chemically stable analogs of inorganic pyrophosphate, which are resistant to breakdown by enzymatic hydrolysis, The biological effects of bisphosphonates on calcium metabolism were originally ascribed to their physico-chemical effects on hydroxyapatite crystals. Although such effects may contribute to their overall action, their effects on cells are probably of greater importance, particularly for the more potent compounds. Remarkable progress has been made in increasing the potency of bisphosphonates as inhibitors of bone resorption, and the most potent compounds in current use are characterized by the presence of a nitrogen atom at critical positions in the side chain which, together with the bisphosphonate moiety itself, seems to be essential for maximal activity, As a class the bisphosphonates offer a very effective means of treating Paget's disease.

Original languageEnglish
Pages (from-to)53-65
Number of pages13
JournalJournal of Bone and Mineral Research
Issue numberSuppl. 2
Publication statusPublished - 1999


  • mold dictyostelium-discoideum
  • cyclical etidronate therapy
  • GTP-binding protein
  • heterocycle-containing bisphosphonates
  • inhibit bone-resorption
  • acute-phase response
  • Pagets-Disease
  • in-vitro
  • dichlormethylene diphosphonate
  • postmenopausal osteoperosis


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