Hyperpharmacotherapy in ageing cystic fibrosis patients: The first report of an atypical hip fracture

Abstract

Cystic fibrosis (CF) is a common autosomal recessive disorder in Caucasian populations with respiratory, gastrointestinal and endocrine manifestations. Thanks to recent advances in medical therapies and infection control, life expectancy of a patient with CF has significantly increased from less than 5 years in the mid-1900s to almost 50 years nowadays. However, as CF patients are living longer, multimorbidity and Hyperpharmacotherapy are becoming more common. This case illustrates a cascade of problems that ensued from medication side-effects, highlighting the increasing challenge of managing an ageing CF population.

The Atraumatic Metatarsal Fracture: A Clinical Sign of Bisphosphonate-Associated Bone Fragility

“…Third, we [21] and others [33,36] have reported prior occurrence, during BP treatment, of MTFs which herald rather than follow an AFF. MTFs while on BP therapy have also been reported as preceding other types of fractures that have been associated with bisphosphonate therapy [1,34]. These facts are inconsistent with the choice of MTFs as a marker of increased holiday risk.…”

Musculoskeletal Abnormalities Caused by Cystic Fibrosis

“…Since CF patients are now frequently treated with allele-specific drugs, there is no evidence to indicate CF patients should have fractures managed any different from patients without a diagnosis of Cystic Fibrosis. In instances of delayed fracture healing, subcutaneous teriparatide may be another effective tool to promote fracture healing, although there is poor quality evidence to support this management [44].…”