The first thing to note about this word is that it is not biphosphonate. That opening syllable is bis, as in “again” in Latin. And what comes again? In this word, spho – not a real morpheme, but just a coincidental sequence. If bis repetitia non placent (repetitions don’t please), one might subject it to haplology and kill one spho to make bisphonate, which, ironically, would seem to mean “sounded twice” or “spoken twice”, as long as we allow the Latin bis to wed with the Greek phone without thinking it phony (a more classical Latin formation would use bi in place of bis, but that’s not our bis-ness here). We have to watch that our derivation is from ϕωνή phóné, “voice”, rather than ϕόνος phonos, “murder”, though… we wouldn’t want to kill it twice (if we killed both sphos we would end up with binate, which would seem to mean “born twice”, even more ironically, and where would we go from there?).
This is a formal-looking word, suited to a bishop, posh, neat. It has many flavours peeking from its orthography: hints of shop, hops, pose, phone, hosp(ital), p(r)onate, tea, and a big bite enclosing a heart set on Sappho (with a spare h). And for those who seek bliss from phonetics, that pair of paired fricatives /sf/ and /sf/ make a sufficient bed as soft as sphagnum moss between the headboard of /b/ and the foot at /neIt/. This is a word with no bones in the heart of it.
It is also a word for something that works on the hearts of bones. Bisphosphonates are a class of drugs used to prevent bone loss. They are used to treat people with osteoporosis; they reduce the risk of bone fracture. How much they reduce it by depends on the specific drug, the fracture site, whether you’ve had a fracture before, and whether you figure by absolute risk or relative risk: they may claim as much as a 45% relative risk reduction but with a 2% absolute risk reduction. I’ll explain the difference. Say you had 100 people with osteoporosis, and without treatment 4 would get a certain fracture, and with the drug 2 would get a fracture. In such a case, the drug cuts the fracture rate in half, from 4 to 2 – a 50% relative risk reduction – but in absolute terms it reduces the risk by only 2%, and you would on average need to treat 50 people for just one to get any benefit. But the problem is you don’t know which one, so you treat all 50. And more than one of them will get the side effects.
If you think you get a taste of phosphorus from this word, you are right. Bisphosphonates are so named because they have tandem phosphonates, and a phosphonate is an assembly of a phosphorus atom, three oxygen atoms, and some other stuff. Binding the two phosphonates is a carbon atom, and also hanging off that are a couple of other chains of stuff; it’s those other chains that differentiate between the different bisphosphonates, just as if along with bisphosphonate we had some other words like trisphosphonation and tetrakisphosphonetics. (Of course we don’t; that’s just philosophical phonetics.) Bisphosphonates work like decoys – when enzymes come along to break down the bones (bones are constantly being broken down and replaced, and the problem is when the rates differ), they step in for the enzymes’ usual dancing partners and keep them from doing anything. It sounds a bit like a seductress in a spy novel stopping an assassin. Perhaps James Bond… I won’t say you only live twice, but a new lease on life is a step in that direction. For the 2% who benefit.