ASBMR Task Force Report on Atypical Femoral Fractures Published in the JBMR

In a review published online in the Journal of Bone and Mineral Research (JBMR), an expert task force convened by the American Society of Bone and Mineral Research reports that bisphosphonates are highly effective in reducing common bone fractures in people with osteoporosis, but long term use of these medications may be related to unusual but serious fractures of the femur.

In a review published online in the Journal of Bone and Mineral Research (JBMR), an expert task force convened by the American Society of Bone and Mineral Research reports that bisphosphonates are highly effective in reducing common bone fractures in people with osteoporosis, but long term use of these medications may be related to unusual but serious fractures of the femur. This expert panel reviewed 310 cases of "atypical femur fractures" and found that 94 percent (291) of patients had taken the drugs, most for more than five years. The task force members emphasized that atypical femur fractures represent less than one percent of hip and thigh fractures overall and therefore are very uncommon.

"For the vast majority of patients with osteoporosis, these drugs are an important weapon against fractures and their benefits far outweigh the risks of using them," said task force co-chair and lead author Elizabeth Shane, M.D., of Columbia University. "Most of the patients who experienced these atypical femur fractures had been taking bisphosphonates for more than five years. However, we are concerned that there may be a relationship between these fractures and long-term bisphosphonate use and, although the risk is low, we want to make sure that people know about the warning signs," she said.

The task force is calling for additional product labeling, better identification and tracking of patients experiencing these breaks, and more research to determine whether and how these drugs cause the serious but uncommon fractures. The task force report is available on the JBMR web site and the Wiley Online Library. JBMR has also issued a press release on the report, which may be viewed on here.
Reference

Shane, E., Burr, D., Ebeling, P. R., Abrahamsen, B., Adler, R. A., Brown, T. D., Cheung, A. M., Cosman, F., Curtis, J. R., Dell, R., Dempster, D., Einhorn, T. A., Genant, H. K., Geusens, P., Klaushofer, K., Koval, K., Lane, J. M., McKiernan, F., McKinney, R., Ng, A., Nieves, J., O'Keefe, R., Papapoulos, S., Sen, H. T., van der Meulen, M. C., Weinstein, R. S. and Whyte, M. (2010), Atypical subtrochanteric and diaphyseal femoral fractures: Report of a Task Force of the American Society for Bone and Mineral Research. Journal of Bone and Mineral Research, 25: 2267–2294. doi: 10.1002/jbmr.253