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

ionship between bisphosphonate use and increase in risk for these fractures, although the relatively small numbers preclude definitive conclusions, according to Black.

"We found that fractures are very rare, less then 3 per 10,000 years of treatment, even in populations treated for a very long time,” Black said. "The trade-off between the risk of this type of fracture and the overall benefit of these medications to osteoporotic patients is striking. The public needs to understand the rare incidence of atypical femoral fractures and the high risk of debilitating fractures in patients with osteoporosis if left untreated. These are important risks and benefits for patients to weigh with their doctors.”

He also recommends that patients taking bisphosphonates long term consult their doctors if they experience pain in their thighs, suggesting "It may be time to consider a drug holiday.”

Black and his team recommend future studies to assess additional risk factors that could identify a subgroup of patients who might be more vulnerable to rare subtrochanteric/diasphyseal femur fractures.

The UCSF researchers say that an increase of risk might be focused on patients who take other medications such as corticosteroids or other medications that treat osteoporosis such as hormone replacement therapy. They suggest further research include observational studies from population-based registries or healthcare databases that retain radiographs as useful alternatives.

The three trials that provided data for the UCSF study are the Fracture Intervention Trial, known as FIT; the FIT Long-Term Extension Trial, known as FLEX; and the Health Outcomes and Reduced Incidence with Zoledronic Acid Once Yearly Pivotal Fracture Trial, known as HORIZON-PFT.

An estimated 10 million Americans have osteoporosis and 34 million more are prone because of low bone density. Patients with significant osteoporosis are
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