Stopping Bone Drug Cuts Risk of Second Thigh Fracture: Study

THURSDAY, Feb. 9 (HealthDay News) —

People who suffer a rare type of fracture of the thigh bone while taking
bone-building drugs known as bisphosphonates can cut the risk of a second
fracture by discontinuing the medication, a new study says.

Bisphosphonates such as Fosamax, Boniva and Actonel are often
prescribed for postmenopausal women or people taking steroid medications
to prevent or slow the bone-weakening disease osteoporosis. But the drugs
have been linked to a small risk of unusual fractures of the femur. One
out of 1,000 taking the drugs for six years will suffer such a fracture,
the researchers said.

For the study, the researchers examined femur fracture records for
patients older than 45 from a large California insurer. Over two years,
they found 126 patients reportedly taking bisphosphonates suffered an
atypical femur fracture.

Of those patients, 41.2 percent who continued taking the drugs suffered
a second femur fracture in the other thigh three or more years later. In
contrast, 19.3 percent of those who stopped taking the medication had a
similar break. Overall, the study revealed, subsequent atypical femur
fractures dropped by 53 percent — more than half — when patients stopped
taking bisphosphonates after the first break.

“The risk of a contralateral atypical femur fracture [on the opposite
side] increases over time if the bisphosphonates are continued,” said lead
investigator Dr. Richard Dell, a researcher in the department of
orthopedics at Kaiser Permanente.

“Based on these observations, we recommend discontinuing bisphosphonate
use as soon as possible after the initial atypical femur fracture has
occurred,” Dell said in a news release from the American Academy of
Orthopaedic Surgeons.

The study authors speculated that bisphosphonates may disrupt the bone
remodeling process, whereby bones replace old tissue with healthy new bone
tissue. The result might be brittle bones that break more easily. In these
cases, the femur is at particular risk.

Patients on bisphosphonates who suffer this rare femur fracture also
need ongoing evaluation since they remain at greater risk for another
break, Dell added. They probably should use another osteoporosis
medication, he said.

The findings were slated for presentation Wednesday at the annual
meeting of the American Academy of Orthopaedic Surgeons in San
Francisco.

Research presented at medical meetings should be considered preliminary
until published in a peer-reviewed medical journal.

More information

The U.S. National Institutes of Health provides more information on osteoporosis.

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