scholarly journals Letter to the Editor: Missing Information and Bias Confounds Relationship Between Manipulation and Atypical Femur Fracture

2021 ◽  
pp. 267-269
Author(s):  
Jude A. Miller ◽  
Robert J. Trager ◽  
Patrick J. Battaglia ◽  
Clinton J. Daniels
Keyword(s):  
Femur Fracture ◽  
Missing Information ◽  
Atypical Femur Fracture ◽  
Letter To The Editor

scholarly journals OR03-4 Atypical Femur Fracture Incidence Increases with Duration of Bisphosphonate Exposure

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Joan Lo ◽  
Christopher Grimsrud ◽  
Susan Ott ◽  
Malini Chandra ◽  
Rita Hui ◽  
...  
Keyword(s):  
Femur Fracture ◽  
Fracture Incidence ◽  
Atypical Femur Fracture

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 Atraumatic segmental atypical femur fracture secondary to bisphosphonate use: A case report

2017 ◽  
Vol 8 ◽  
pp. S67-S71 ◽  
Author(s):  
Andrew J. Lovy ◽  
Diana Patterson ◽  
Laura Skeeles ◽  
Richard Ghillani ◽  
David Joseph ◽  
...  
Keyword(s):  
Case Report ◽  
Femur Fracture ◽  
Atypical Femur Fracture

Atypical femur fracture during bisphosphonate drug holiday: a case series

2015 ◽  
Vol 26 (6) ◽  
pp. 1755-1758 ◽  
Author(s):  
A. J. Lovy ◽  
S. M. Koehler ◽  
A. Keswani ◽  
D. Joseph ◽  
R. Hasija ◽  
...  
Keyword(s):  
Femur Fracture ◽  
Case Series ◽  
Drug Holiday ◽  
Atypical Femur Fracture

scholarly journals Bilateral Atypical Femur Fracture in a Patient Under Bisphosphonate Treatment

2019 ◽  
Vol 23 (3) ◽  
pp. 187-190 ◽  
Author(s):  
Duygu ŞİLTE KARAMANLIOĞLU ◽  
Meryem KAYSIN ◽  
Naciye BİLGİN BADUR ◽  
Feyza ÜNLÜ ÖZKAN ◽  
İlknur AKTAŞ
Keyword(s):  
Femur Fracture ◽  
Bisphosphonate Treatment ◽  
Atypical Femur Fracture

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 Atypical Femur Fracture Risk versus Fragility Fracture Prevention with Bisphosphonates

2020 ◽  
Vol 383 (8) ◽  
pp. 743-753 ◽  
Author(s):  
Dennis M. Black ◽  
Erik J. Geiger ◽  
Richard Eastell ◽  
Eric Vittinghoff ◽  
Bonnie H. Li ◽  
...  
Keyword(s):  
Fracture Risk ◽  
Fragility Fracture ◽  
Femur Fracture ◽  
Fracture Prevention ◽  
Atypical Femur Fracture

scholarly journals Bisphosphonate-Associated Atypical Femur Fracture

2014 ◽  
Vol 44 (1) ◽  
pp. 35-37 ◽  
Author(s):  
Van T Nguyen ◽  
Mahipal G Sinnollareddy
Keyword(s):  
Femur Fracture ◽  
Atypical Femur Fracture
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