Bisphosphonates (BPs) are the drug of choice for treating bone diseases such as osteoporosis, Paget's disease, and metastatic bone disease. BPs with nitrogen-containing side chains (N-BPs) are known to act as inhibitors for farnesyl pyrophosphate synthase (FPPS), a key enzyme in the mevalonate pathway. In this study, we evaluated the effect of different side chains on the binding affinity of BPs to human FPPS using calorimetric techniques. Differential scanning calorimetry (DSC) was used to determine the thermal unfolding of FPPS in the presence of BPs. The addition of a series of clinically available BPs increased the structural stability of human FPPS by preferential binding, as indicated by an increase in the FPPS unfolding temperature. The magnitude of the increase was correlated with in vivo antiresorptive efficacy, suggesting that the stabilization of FPPS underlies the inhibitory effect of the BPs. Isothermal titration calorimetry (ITC) experiments were performed to evaluate the binding thermodynamics of BPs against human FPPS. Analysis of the binding energetics revealed that over 30 years of optimization practiced by different pharmaceutical companies has enhanced the enthalpic contribution as well as binding affinity of BPs. The larger enthalpic contribution observed for newer, more potent BPs derives from both improved hydrogen bonding interactions and shape complementarity based on comparisons of our results with available structure information.Key words isothermal titration calorimetry; thermodynamics; drug discovery; enthalpy; differential scanning calorimetry Osteoporosis is a bone disease which leads to increased bone fragility and fracture risk. In osteoporosis, bone mineral density is reduced, bone microarchitecture deteriorates, and both the amount and variety of proteins in the bone are altered. The most common cause of this disease is increased bone turnover with excessive bone resorption that exceeds bone formation. Bisphosphonates (BPs) are a class of drugs widely used to treat diseases characterized by bone resorption, such as osteoporosis, Paget's disease, and metastatic bone disease.1-4) The two phosphate groups in the P-C-P structure of BPs are known to be important for BP interaction with a molecular target in the osteoclast and for the high affinity to bone mineral, both of which are required for BPs to inhibit bone resorption. [4][5][6] As shown in Fig. 1, side chains attached to the central carbon of the P-C-P allow for a wide range of possible chemical structures of clinically available drugs.3) However, while a wide variety of side chain structures has evolved from 30 years of research and development at different pharmaceutical companies, what underlies progression towards quality compounds in terms of thermodynamics of binding to a target remains unclear.First-generation BPs such as etidronate and clodronate have non-nitrogenous (non-N) side chains and act as pyrophosphate analogues. These non-N-BPs are metabolized to non-hydrolyzable cytotoxic ATP analogues that accumulate intr...