Thursday, 18 Jan 2018

You are here

Higher Fracture Risks with Prolonged Bisphosphonate Use in Older Women

It is estimated that 50% of women over the age of 50 will experience a facture related to osteoporosis. And while there are many effective therapies to lower this risk, the optimal duration of treatment is the subject of current debate.

The Journal of the American Geriatric Society has reported that older women receiving bisphosphonate therapy for greater than 10-13 years were more likely to suffer from fractures. ( Citation source: http://buff.ly/2qL1yQK)

In a subset observational study from the Womens Health Initiative, 5,120 older women who received bisphosphonates for greater than 2 years were assessed at different time intervals based on years of bisphosphonate use (2 years, 3–5, 6–9, 10–13 years). Fracture risk was calculated using 2 years as the referent group.

The length of time on bisphosphonates varied, with 13% takng bisphosphonates for 2 years,  34% for 3-5 years, 20% for 6-9 years, and 33% for 10-13 years.

The aveage age was 80 years and there were a total of 1313 fractures:127 hip, 159 wrist/forearm, and 235 vertebral fractures.

With 10-to-13 years of bisphosphonate use a 29% higher risk of any and all fractures was seen compared to 2 years of use (HR = 1.29, 95%CI; 1.07–1.57).  However, this was not statistically significant for hip (HR = 1.66, 95% CI = 0.81–3.40), clinical vertebral (HR = 1.65, 95% CI = 0.99–2.76), or wrist fracture (HR = 1.16, 95% CI = 0.67–2.00).

In older women at high risk of fracture, it appears that prolonged use (10-to-13 years) of bisphosphonate use was associated with higher risk of any clinical fracture compared to shorter periods (2 years) of use.  

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

Add new comment

More Like This

New Rise in Hip Fractures Amongst Women

Reuters reports that the incidence of hip fractures in older women in the U.S. is rising after more than a decade of decline, according to a large new study of Medicare recipients.

Calcium and Vitamin D Supplements Do Not Reduce Hip Fractures

Recent JAMA study shows metanalysis of 33 clinical trials and 51,145 participants, showed that calcium, vitamin D, or both affords no decreased risk of hip fractures compared with placebo or no treatment and therefore questions their routine widespread use in the elderly.. 

Community Screening for Fracture Risk in Older Women is Effective and Feasible

A UK Study published in Lancet shows that community-based screening programme for fracture risk in older women is feasible, and may reduce hip fractures. 

Older women, age 70-85 yrs, were identified and participated in the trial and were assessed using the Fracture Risk Assessment Tool (FRAX) with usual management. 12 483 were enrolled and 6233 women randomly assigned to the screening group.

Knee Surgery Outcomes Worse with Low Education

Reuters reports that patients who live in low-income communities and lack a college education may have worse pain after knee replacement surgery than their more educated neighbors, citing results from a recent study from the Hospital for Special Surgery in NY.

Weight Loss Does Not Protect OA Knees

A new study presented at the Radiological Society of North America (RSNA) shows that obese people with substantial weight loss may significantly slow down the rate of joint space narrowing (cartilage degeneration) in the knee cartilage, but only if they lose weight through diet and exercise or diet alone; excercise alone is insufficient.