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Prolonged Bisphosphonate Use Tied to Fracture Risk

Older women at increased risk of subtrochanteric or femoral shaft fracture

TUESDAY, Feb. 22 (HealthDay News) -- Bisphosphonate therapy lasting more than five years is associated with an increased risk of subtrochanteric or femoral shaft fractures in older women, according to a study published in the Feb. 23 issue of the Journal of the American Medical Association.

Laura Y. Park-Wyllie, Pharma.D., from St. Michael's Hospital in Toronto, and colleagues studied the association between bisphosphonate therapy and the risk of hospitalization for subtrochanteric or femoral shaft or typical osteoporotic fractures (femoral neck or intertrochanteric region). Women aged 68 years or older, who started oral bisphosphonate therapy between 2002 and 2008, were followed until 2009.

The investigators found that, following the initiation of bisphosphonate therapy, 9,723 women sustained typical osteoporotic fractures, and 716 women sustained subtrochanteric or femoral shaft fractures. Compared to transient use, bisphosphonate use for five years or longer was linked to an elevated risk of subtrochanteric or femoral shaft fractures (odds ratio [OR], 2.74), and a decreased risk of typical osteoporotic fractures (OR, 0.76). In 52,595 women treated with bisphosphonates for at least five years, 0.13 percent suffered subtrochanteric or femoral shaft fractures in the subsequent year and 0.22 percent within two years.

"Our findings provide strong evidence that prolonged bisphosphonate therapy is associated with an increased risk of subtrochanteric or femoral shaft fracture, although the absolute risk of these fractures is low," the authors write. "Long-term use of these drugs may warrant reconsideration, especially in patients at relatively low risk of fracture."

One author disclosed financial ties with several pharmaceutical companies.

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