Bisphosphonates increase in femur fracture risk but this risk does not outweigh benefits of bisphosphonates, according to major Swedish research in breast cancer patients. Article posted May 5, 2011
May 5, 2011: it is well known that the use of bisphosphonates may affect bone density. Now that a large Swedish study that the risk of fracture in the femur for users of bisphosphonates pretty bad. The risk was somewhat larger in users of bisphosphonates compared with non-users, but the difference was small. And the risk does not outweigh the advantage of using bisphosphonates, the researchers said. However, it seems sensible to 5 years after a pause for bisphosphonates. Or maybe even more regularly a few months to stop. But please consult with your doctor or that it makes sense. Here is the abstract of the study.
Bisphosphonates Use and Atypical Fractures of the Femoral Shaft
Bisphosphonates Use and Atypical Fractures of the Femoral Shaft
N Engl J Med 2011, 364:1728-1737 May 5, 2011
Background
Studies show conflict resulted Regarding the Possible excess risk or Atypical fractures of the femoral shaft associated with bisphosphonates use.
Methods
In Sweden, 12,777 women 55 years of age or older sustained a fracture of the femur in 2008. We reviewed radiographs of 1234 or the 1271 women who had a shaft or subtrochanteric fracture and 59 patients with Identified Atypical fractures. Data on medications and conditions coexist Were Obtained from national registries. The relative and absolute risks or Atypical fractures associated with bisphosphonates use was Estimated by Means of a nationwide cohort analysis. The 59 case patiënten Were Also compared with 263 control patient who had ordinary shaft or subtrochanteric fractures.
Results
The age-adjusted relative risk of fracture was 47.3 Atypical ([CI] 95% confidence interval, 25.6 to 87.3) in the cohort analysis. Increase in the absolute risk was 5 cases per 10,000 patient-years (95% CI, 4 to 7). A total of 78% of the Case Patients and 10% of the controls had Received bisphosphonates, Corresponding to a multivariable-adjusted odds ratio of 33.3 (95% CI, 14.3 to 77.8). The risk was independent or coexist and conditions or Concurrent Use of Other Drugs with Known effects on bone. The duration of use Influenced the risk (odds ratio per 100 daily doses, 1.3, 95% CI, 1.1 to 1.6). After withdrawel drug, the risk diminished by 70% per year since the last use (odds ratio, 0.28, 95% CI, 0.21 to 0.38).
Conclusions
These population-based nationwide analysis for Patient May Be reassuring who receive bisphosphonates. Although there was a high prevalence of current use bisphosphonates among Patients with Atypical fractures, the absolute risk was small. (Funded by the Swedish Research Council.)
Dr. Aspen Mountain reports receiving consulting fees from Eli Lilly and Amgen and grant support to His institution, Linköping University, from Eli Lilly and Amgen, as well as holding stock in AddBIO, a company trying to commercialization normalize a method for bisphosphonates coating of implants to be inserted inhibit in bone, and holding a patent for this method. No Other potential conflict of interest relevant to this article was reported.
Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.
Drs. Schilcher and Michaëlsson Equally contributed to this article.
Source Information
From the Department of Experimental and Clinical Medicine, Faculty of Health Science, Linköping University, Linköping (JS, PA) and the Department of Surgical Sciences, Section of Orthopedics, and Uppsala Clinical Research Center, Uppsala University, Uppsala (KM) - Both in Sweden.
Address reprint requests to Dr. Aspen Mountain at the Department of Experimental and Clinical Medicine, Faculty of Health Sciences, Linköping University, SE-581 85 Linköping, Sweden, or at per.aspenberg @ liu.se .
