Friday, 25 May 2018

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Bisphosphonate Drug Holidays May Result in Fractures

A report in Endocrine Practice shows that drug holidays from bisphosphonates results in a 15% risk of fractures.  (Citation source: http://bit.ly/2FHbFwp)

A retrospective chart review of 401 osteoporosis or osteopenia patiens from Loyola who took a drug holiday between 2004 to 2013 found an annual incidence of fractures ranged from 3.7 to 9.9%, peaking at 9.9% and 9.8% during years 4 and 5, respectively.

Fracture patients had higher mean ages (69.24 ± 12.26 years vs. 66.42 ± 10.18 years; P = .09), lower femoral neck BMD (0.75 ± 0.12 g/cm2 vs. 0.79 ± 0.10 g/cm2; P = .03) and lower T-scores (-2.13 ± 0.99 vs. -1.78 ± 0.79; P = .01) at baseline.

The American Association of Clinical Endocrinologists and American College of Endocrinology recommend that women at moderate risk for osteoporosis take a drug holiday after five years of oral and three years of intravenous bisphosphonate treatment. Women at higher risk for osteoporosis should take a drug holiday after 10 years of oral and six years of intravenous bisphosphonate treatment.

This study questions how long drug holidays should last. These patients had taken bisphosphonates for an average of 6.3 years before beginning drug holidays. .

Overall, 62 (15.4%) experienced fractures after going on drug holidays. The most common sites were the wrist, foot, ribs and spine.

 

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

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