Can long-term bisphosphonate use causes low-energy fractures? A case report

Osteoporos Int. 2014 Feb;25(2):773-6. doi: 10.1007/s00198-013-2428-0. Epub 2013 Jul 4.

Abstract

Bisphosphonates are inorganic pyrophosphate analog which accumulate on the bone surface, cause osteoclast apoptosis, and inhibit bone resorption. The nitrogen-containing bisphosphonates continue to be the drug of choice for the treatment of osteoporosis in both men and women. Although histomorphometric studies including bone biopsies have not shown any evidence of microcracks, recent studies have revealed that potent bisphosphonates are responsible for the oversuppression of bone turnover leading to microdamages, reduced bone strength, and increased fracture risk. There are individual cases reporting atypical femoral fractures and severely suppressed bone turnover along with long-term (≥ 5 years) use of biphosphonates. In this study, we report on a 74-year-old woman with a history of continuous alendronate use for nearly 16 years who presented to the emergency department with right proximal humerus and left femur fracture.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Bone Density Conservation Agents / administration & dosage
  • Bone Density Conservation Agents / adverse effects*
  • Bone Density Conservation Agents / therapeutic use
  • Diphosphonates / administration & dosage
  • Diphosphonates / adverse effects*
  • Diphosphonates / therapeutic use
  • Drug Administration Schedule
  • Female
  • Femoral Fractures / chemically induced
  • Femoral Fractures / diagnostic imaging
  • Fractures, Spontaneous / chemically induced*
  • Fractures, Spontaneous / diagnostic imaging
  • Humans
  • Humeral Fractures / chemically induced
  • Humeral Fractures / diagnostic imaging
  • Osteoporosis, Postmenopausal / drug therapy
  • Radiography

Substances

  • Bone Density Conservation Agents
  • Diphosphonates