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Table 1 Bisphosphonates: types and mode of action

From: Bisphosphonate-related osteonecrosis of jaw (BRONJ): diagnostic criteria and possible pathogenic mechanisms of an unexpected anti-angiogenic side effect

Generation

Type

Examples

Mode of action

First

NNBPs

Etidronate

Formation of an ATP derivative that impairs osteoclast function and induces osteoclastic apoptosis

Clodronate

Tiludronate

Second

Alkyl-amino NBPs

Pamidronate

Inhibits sterol synthesis via the mevalonate pathway specifically inhibiting its Farnesyl pyrophosphate synthase (FPPS) enzyme

Alendronate

Ibandronate

Olpadronate

Third

Heterocyclic NBPs

Risedronate

Inhibits FPPS enzyme and stabilize conformational changes

  

Zoledronate

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