Bisphosphonates Tied to Small Risk of Atypical Fractures

Despite high prevalence of drug use in patients with atypical fractures, absolute risk is small

WEDNESDAY, May 4 (HealthDay News) -- Among patients with atypical fractures, there is a high prevalence of current bisphosphonate use, but the absolute risk of these fractures is small, according to a study published in the May 5 issue of the New England Journal of Medicine.

Jörg Schilcher, M.D., of Linköping University in Sweden, and colleagues reviewed radiographs of 1,234 women who had a subtrochanteric or shaft fracture and identified 59 patients with atypical fractures. The investigators compared the 59 case patients with 263 control patients who had ordinary subtrochanteric or shaft fractures.

The investigators found that the age-adjusted relative risk of atypical fracture was 47.3, with an increase in absolute risk of five cases per 10,000 patient-years. They found that 78 percent of the case patients and 10 percent of the controls had received bisphosphonates (multivariable adjusted odds ratio [OR], 33.3). The duration of use influenced the risk (OR per 100 daily doses, 1.3). After withdrawal from the drug, the risk decreased by 70 percent per year since last use (OR, 0.28).

"These population-based nationwide analyses may be reassuring for patients who receive bisphosphonates. Although there was a high prevalence of current bisphosphonate use among patients with atypical fractures, the absolute risk was small," the authors write.

One author disclosed financial relationships with Eli Lilly, Amgen, and AddBIO, a company trying to commercialize a method for bisphosphonate coating of implants inserted in bone.

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