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Benefits of Osteoporosis Treatments Outweigh Possible Risk of Rare Femoral Fractures
Date:3/24/2010

land Journal of Medicine.

Bisphosphonates (marketed as Fosamax, Actonel, Boniva, and Reclast) are the most commonly used treatment for postmenopausal osteoporosis. They belong to the class of anti-restorative drugs that act by slowing bone degradation, or desorption, and thereby increase bone density and reduce the risk of fractures.

The UCSF researchers focused on fractures in the shaft of the femur. Breaks in this region are much less common than hip fractures that occur closer to the top of the bone and are most commonly associated with trauma.

Case reports in recent years have reported femur breaks in patients taking bisphosphonates, occurring with little trauma and having an atypical appearance on x-rays. However, there has been no rigorous large scale study to determine a relationship.

The UCSF study is now the first to do this, using data from the records of a total of 14,195 women who participated in three previous controlled, randomized bisphosphonate trials. The women ranged in age from 65 to 85, and the studies followed them for up to 10 years. There was a total of over 51,000 years of follow up in the three studies combined.

Black's team reevaluated the records for femur fractures in the three trials: two that studied use of oral alendronate (a placebo-controlled phase III trial and randomized extension to 10 years treatment) and one on the use of zoledronic acid (a placebo-controlled trial with the drug infused annually). The trials used similar protocols for original collection and classification of fractures.

In their analysis, the UCSF researchers considered the location of the fracture and compared occurrence in patients who received bisphosphonates versus those who received placeboes.

They reviewed records of 283 hip or femur fractures and found a total of 12 fractures in 10 women that were classified as subtrochanteric/diasphyseal femur fractures. They found no significant relat
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