scholarly journals The association of race/ethnicity and risk of atypical femur fracture among older women receiving oral bisphosphonate therapy

Bone ◽  
2016 ◽  
Vol 85 ◽  
pp. 142-147 ◽  
Author(s):  
Joan C. Lo ◽  
Rita L. Hui ◽  
Christopher D. Grimsrud ◽  
Malini Chandra ◽  
Romain S. Neugebauer ◽  
...  
Keyword(s):  
Older Women ◽  
Femur Fracture ◽  
Bisphosphonate Therapy ◽  
Atypical Femur Fracture ◽  
Oral Bisphosphonate ◽  
Race Ethnicity

scholarly journals Risk of complete atypical femur fracture with Oral bisphosphonate exposure beyond three years

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Joan C. Lo ◽  
Romain S. Neugebauer ◽  
Bruce Ettinger ◽  
Malini Chandra ◽  
Rita L. Hui ◽  
...  
Keyword(s):  
Cumulative Incidence ◽  
Femur Fracture ◽  
Demographic Data ◽  
Large Population ◽  
Risk Difference ◽  
Atypical Femur Fracture ◽  
Oral Bisphosphonate ◽  
Increased Risk ◽  
Incidence Risk ◽  
Fracture History

Abstract Background Bisphosphonate (BP) therapy has been associated with atypical femur fracture (AFF). However, the threshold of treatment duration leading to increased AFF risk is unclear. In a retrospective cohort of older women initiating BP, we compared the AFF risk associated with treatment for at least three years to the risk associated with treatment less than three years. Methods We used observational data from a large population of female members of an integrated healthcare system who initiated oral BP during 2002–2014. Women were retrospectively followed for incident AFF confirmed by radiologic adjudication. Demographic data, pharmacologic exposures, comorbidity, bone density, and fracture history were ascertained from electronic health records. Inverse probability weighting was used to estimate risk differences comparing the cumulative incidence (risk) of AFF if women discontinued BP within three years to the cumulative incidence of AFF if women continued BP for three or more years, adjusting for potential time-dependent confounding by the aforementioned factors. Results Among 87,820 women age 45–84 years who initiated BP (mean age 68.6, median T-score − 2.6, 14% with prior major osteoporotic fracture), 16,180 continued BP for three or more years. Forty-six confirmed AFFs occurred during follow-up in the two groups. AFF-free survival was greater for BP treatment < 3 years compared to treatment ≥3 years (p = 0.004 comparing areas under survival curves). At five years, the risk of AFF was 27 per 100,000 (95% confidence interval, CI: 8–46) if women received BP treatment < 3 years and 120 per 100,000 (95% CI: 56–183) if women received BP treatment ≥3 years (risk difference 93 per 100,000, 95% CI: 30–160). By ten years, the risks were 27 (95% CI: 8–46) and 363 (95% CI: 132–593) per 100,000 for BP treatment < 3 and ≥ 3 years, respectively (risk difference 336 per 100,000, 95% CI: 110–570). Conclusions Bisphosphonate treatment for 3 or more years was associated with greater risk of AFF than treatment for less than 3 years. Although AFFs are uncommon among BP-treated women, this increased risk should be considered when counseling women about long-term BP use. Future studies should further characterize the dose-response relationship between BP duration and incident AFF and identify patients at highest risk.

scholarly journals Antiresorptive-associated spontaneous fractures of both tibiae, followed by an atypical femur fracture during the sequential treatment with alendronate, denosumab then teriparatide

2019 ◽  
Vol 12 (7) ◽  
pp. e229366 ◽  
Author(s):  
Juan Tan ◽  
Hiroshige Sano ◽  
Kenneth Poole
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Femur Fracture ◽  
Bisphosphonate Therapy ◽  
Antiresorptive Therapy ◽  
Atypical Fracture ◽  
Atypical Femur Fracture ◽  
Atypical Fractures ◽  
Alendronate Treatment ◽  
Careful Investigation

A 35-year-old man with juvenile idiopathic arthritis since childhood presented with bilateral atypical tibial fractures, followed by a later, single atypical fracture of the femur. The fractures were associated with 6 years of oral alendronate treatment immediately followed by subcutaneous denosumab therapy and later teriparatide therapy for osteoporosis. Atypical fractures are known to occur in the femur following bisphosphonate therapy; however, there are only a few documented cases of atypical fractures in the tibia. Our case highlights a rare but serious complication of a commonly prescribed antiresorptive agent. It also shows that teriparatide, while helpful in increasing bone mass, does not fully prevent the development of atypical fractures. Careful investigation should be considered in patients on long-term antiresorptive therapy presenting with bony tenderness to exclude an atypical fracture.

scholarly journals Bone Structure and Turnover Status in Postmenopausal Women with Atypical Femur Fracture After Prolonged Bisphosphonate Therapy

2016 ◽  
Vol 100 (3) ◽  
pp. 235-243 ◽  
Author(s):  
Shijing Qiu ◽  
George W. Divine ◽  
Saroj Palnitkar ◽  
Pooja Kulkarni ◽  
Trent S. Guthrie ◽  
...  
Keyword(s):  
Postmenopausal Women ◽  
Bone Structure ◽  
Femur Fracture ◽  
Bisphosphonate Therapy ◽  
Atypical Femur Fracture

Oral Health Considerations in Older Women Receiving Oral Bisphosphonate Therapy

2011 ◽  
Vol 59 (5) ◽  
pp. 916-922 ◽  
Author(s):  
Joan C. Lo ◽  
Felice O'Ryan ◽  
Jingrong Yang ◽  
Mohammad K. Hararah ◽  
Joel R. Gonzalez ◽  
...  
Keyword(s):  
Oral Health ◽  
Older Women ◽  
Bisphosphonate Therapy ◽  
Oral Bisphosphonate

scholarly journals A case of atypical femur fracture during long-term treatment with bisphosphonates in patient with postmenopausal osteoporosis

2019 ◽  
Vol 22 (1) ◽  
pp. 18-23
Author(s):  
Kira E. Zotkina ◽  
Olga M. Lesnyak ◽  
Aleksandr Yu. Kochish ◽  
Ivan V. Sushkov
Keyword(s):  
Postmenopausal Osteoporosis ◽  
Femur Fracture ◽  
Term Treatment ◽  
Atypical Femur Fracture ◽  
First Line Therapy ◽  
Oral Bisphosphonate ◽  
Long Term Treatment ◽  
Rare Side Effect ◽  
The Right

Bisphosphonates is a first-line therapy for treatment of osteoporosis. In the last decade, the number of atypical femur fracture (AFF) cases during long-term treatment with bisphosphonates has increased. The aim of this article was to analyze the literature data on this problem, to define the diagnostic criteria of AFF and to present the case of AFF in the patient who received treatment with alendronate for 3.5 years. A 78-year-old woman, receiving oral bisphosphonate for severe postmenopausal osteoporosis for 3.5 years, suddenly started feeling pain in her right thigh while walking. Three months later, she had got a fracture in middle third of the right femur after falling from her standing height. According to instrumental diagnostics, this fracture had all criteria of AFF. Blocking intramedullary osteosynthesis with shafts was performed. A retrospective analysis of soft tissue magnetic resonance imaging in the area of right thigh, done before the fracture, showed the presence of undiagnosed incomplete right femur fracture in the middle third, which subsequently led to a complete fracture. Presented clinical case demonstrates the complexity of AFF diagnostics. The purpose of the publication is to draw attention of medical specialists to the issue of this rare side effect of bisphosphonate treatment.

scholarly journals Long-Term Oral Bisphosphonate Therapy and Fractures in Older Women: The Women's Health Initiative

2017 ◽  
Vol 65 (9) ◽  
pp. 1924-1931 ◽  
Author(s):  
Rebecca L. Drieling ◽  
Andrea Z. LaCroix ◽  
Shirley A. A. Beresford ◽  
Denise M. Boudreau ◽  
Charles Kooperberg ◽  
...  
Keyword(s):  
Women’S Health ◽  
Women's Health ◽  
Older Women ◽  
Bisphosphonate Therapy ◽  
Women's Health Initiative ◽  
Women’S Health Initiative ◽  
Health Initiative ◽  
Oral Bisphosphonate ◽  
The Women’S Health Initiative
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