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Osteoporosis Imprimer
Bisphosphonates and Fractures of the Subtrochanteric or Diaphyseal Femur ?
A secondary analyses using the results of three large, randomized bisphosphonate trials were performed: the Fracture Intervention Trial (FIT), the FIT Long-Term Extension (FLEX) trial, and the Health Outcomes and Reduced Incidence with Zoledronic Acid Once Yearly (HORIZON) Pivotal Fracture Trial (PFT). Fracture records and radiographs (when available) from all hip and femur fractures were reviewed to identify those below the lesser trochanter and above the distal metaphyseal flare (subtrochanteric and diaphyseal femur fractures) and to assess atypical features: 284 records for hip or femur fractures among 14,195 women in these trials were reviewed. A total of 12 fractures in 10 patients were classified as occurring in the subtrochanteric or diaphyseal femur, a combined rate of 2.3/ 10,000 patient-years. As compared with placebo, the RH was 1.03 (95% CI, 0.06-16.46) for alendronate use in the FIT trial, 1.50 (95% CI, 0.25- 9.00) for zoledronic acid use in the HORIZON-PFT trial, and 1.33 (95% CI, 0.12- 14.67) for continued alendronate use in the FLEX trial. Although increases in risk were not significant, confidence intervals were wide.
Conclusions The occurrence of fracture of the subtrochanteric or diaphyseal femur was very rare, even among women who had been treated with bisphosphonates for as long as 10 years. There was no significant increase in risk associated with bisphosphonate use, but the study was underpowered for definitive conclusions.

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COGI Berlin 4-7/11/2010


Preconception Care and Health Congress


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