Friday, 18 Jan 2019

You are here

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

Add new comment

More Like This

FDA Panel Backs Approval of Romosuzumab for Osteoporosis

The US Food and Drug Administration’s advisory committee on Bone, Reproductive and Urologic Drugs voted Wednesday in favor of approving Amgen’s osteoporosis anti-sclerostin drug, romosozumab (Evenity) for use women with postmenopausal osteoporosis. 

Reuters reports that the panel voted 16-1 in favor of the monthly injection developed jointly by UCB.

Heberden’s Nodes Predict Knee OA Progression

Hand and knee osteoarthritis are considered to be clinically and pathogenically different and distinct, but a new study suggests that Heberden's nodes (HNs) can predict MRI‐based knee osteoarthritis (OA) progression.

An NIH study of 575 subjects included clinical examination with evaluation of HNs at baseline and knee MRI at baseline and 24‐month.

NEJM Review - Glucocorticoid-Induced Osteoporosis

Lenore Buckley and Mary Humphrey have published a nice review of glucocorticoid-induced osteoporosis (GIOP) in the NEJM.

Uncertain Long Term Efficacy in Trials of Knee Osteoarthritis

A systematic review and network meta-analysis of 47 randomized clinical trials in knee osteoarthritis finds uncertainty around estimates of effect size for pain scores thereby casting uncertainty over the long-term efficacy of medications for knee osteoarthritis.

Zolendronate Protects Against Fracture in Osteopenia

The NEJM reports that the use of zoledronate significantly reduces the risk of nonvertebral or vertebral fragility fractures in women with osteopenia.

While it is known that bisphonates have beneficial effects in osteoporosis, their impact in osteopenia has not been shown.