Table 11.

Effect of Bisphosphonate Treatment on Progression of Hearing Loss

Risk‐benefit balance

The effects of bisphosphonates on progression of hearing loss have not been adequately studied.

Quality of evidence

Very low

Patient values and preferences

Prevention of progression of hearing loss is likely to be valued by patients with PDB. If treatment strategies could be identified that were effective in preventing progression of hearing loss, it is likely that they would be favored by patients.

Costs and use of resources

Bisphosphonates are inexpensive, but intravenous therapy involves additional support costs and costs in terms of patient time attending for the infusion that may need to be considered.

Recommendation

There is insufficient evidence that bisphosphonate therapy prevents progression of hearing loss in PDB, and they are not recommended for this indication.