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  • Older women who use bisphosphonate for longer than 5 years may have increased odds of a subtrochanteric or femoral shaft fracture, but absolute risk is low

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Aetiology
Case control study
Older women who use bisphosphonate for longer than 5 years may have increased odds of a subtrochanteric or femoral shaft fracture, but absolute risk is low
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  1. Bo Abrahamsen
  1. Department of Medicine, Gentofte Hospital, Copenhagen, Denmark
  1. Correspondence to Bo Abrahamsen
    Department of Medicine, Gentofte Hospital, Niels Andersensvej 65 Hellerup DK-2900, Denmark; b.abrahamsen{at}physician.dk

https://doi.org/10.1136/ebm.2011.000013

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    Commentary on: Park-Wyllie LY, Mamdani MM, Juurlink DN, et al. Bisphosphonate use and the risk of subtrochanteric or femoral shaft fractures in older women. JAMA 2011;305:783–9.OpenUrlCrossRefPubMedWeb of Science

    Context

    It is now recognised that fractures of the subtrochanteric femur or femoral shaft (ST/FS fractures) can be divided radiologically into (1) typical fractures and (2) atypical fractures. The latter appear to be rare in patients untreated by bisphosphonates. In this new study, Park-Wyllie et al used Ontario claims data to investigate the association between the amount of bisphosphonates taken and the risk of ST/FS fractures.

    Methods

    The study was a nested 5:1 case-control study, linking prescriptions with hospitalisations, physician service claims and death certificates. Women aged 68 years or older who filled prescriptions for bisphosphonates at least once over a 6-year period were included. Those with malignant disease in the past 10 years, specific bone diseases or secondary causes of osteoporosis (past 5 years) and osteoporosis treatment in the past year were excluded, providing 205 466 women for study.

    Cases were defined as first ST/FS fracture, excluding fractures treated …

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