Effect of early administration of alendronate after surgery for distal radial fragility fracture on radiological fracture healing time

Uchiyama, Shigeharu; Itsubo, Toshiro; Nakamura, Kōichi; Fujinaga, Yasunari; Sato, Nobutaka; Imaeda, Toshihiko; Kadoya, Masumi; Kato, Hiroyuki

doi:10.1302/0301-620x.95b11.31652

Cited by 31 publications

(24 citation statements)

References 41 publications

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“…Figure 1 illustrates the process of study selection. Ten trials [25][26][27][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46] were finally designed to evaluate the effect of the timing of BP initiation after surgery for fracture healing and fulfilled the inclusion criteria for published studies (including safety reports), including a large-scale multicultural RCT with a large number of reports written about it [26,27,[38][39][40][41][42][43][44][45][46].…”

Section: Resultsmentioning

confidence: 99%

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Timing of the initiation of bisphosphonates after surgery for fracture healing: a systematic review and meta-analysis of randomized controlled trials

Cai

Zhang

2014

Osteoporos Int

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Section: Resultsmentioning

confidence: 99%

“…Regarding sex, 22.4 % (n=646) [29,31,37], five trials were hip fracture [27,30,34,35,37,47], and one trial included spinal fractures [25]. The overall mean age was 74.2 years.…”

Section: Patient Characteristicsmentioning

confidence: 99%

Timing of the initiation of bisphosphonates after surgery for fracture healing: a systematic review and meta-analysis of randomized controlled trials

Cai

Zhang

2014

Osteoporos Int

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“…Uchiyama et al, in 2013, [9] concluded from their study that administration of alendronate, early on after an operatively treated distal radius fracture did not seem to delay the healing of the fracture either radiologically or clinically, from their analysis of 80 patients overall with [14] to examine how bone loss after a fracture in women having Colles' fracture and postmenopausal osteoporosis is affected by alendronate; a 10 mg dosage of the drug or placebo was administered to 37 women who were diagnosed with distal forearm fracture and low bone mineral density (BMD) of the lumbar spine. Heightened levels of resorption combined with decreased formation resulted in bone loss after a fracture occurrence and in the immobilization period.…”

Section: Discussionmentioning

confidence: 98%

“…Alendronate acts as a potent antiresorptive agent and inhibits farnesyl pyrophosphate synthase in osteoclasts, which need prenylated proteins for their function and survival [9]. As described in the paper by Uchiyama et al [9] in 2013, the process of fracture healing is in the following order, though there exists some overlap between the stages: Inflammation, soft callus formation, hard callus formation, and hard callus remodeling. In the hard callus remodeling stage, osteoclasts are very much active.…”

Section: Discussionmentioning

confidence: 99%

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Effect of Alendronate on the Healing Time of Distal Radial Fractures Treated Conservatively: An Observational Study

Koshy

Pinto

Sujir

et al. 2017

Asian J Pharm Clin Res

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Objective: Although fragility fractures of the distal radius are common, osteoporosis treatment requires exploration as attempts to improve postfracture investigations have been only partially successful. Bisphosphonates may help minimize the risk of secondary fractures but being a potent antiresorptive agent; it raises concerns about adverse effects on the healing process. This observational study examines the effect of bisphosphonate (alendronate) on healing of acute fractures of distal radius through 66 patients aged >45 years admitted to two tertiary care hospitals in Mangalore from May 2014 to September 2016. Methods:The methodology consists of purposive sampling from two groups: Control having 33 patients not on alendronate therapy and cases comprising 33 who are on alendronate as part of prophylaxis for osteoporosis before fracture occurrence, with outpatient reviews at 2-week intervals starting from the 6 th till fracture union seen. At each visit, plain radiographs of the involved wrist were taken to yield time to cortical bridging, with range of active movement of the affected wrist taken using a goniometer. Data were analyzed using Statistical Package for the Social Sciences software version 17.0 for t values, p values and correlations and results were presented in the form of graphs and tables.Results: No significant differences were observed in the groups (as per p values) w.r.t. gender (0.804), age (0.835), time to healing (1.000), dorsiflexion (0.956), palmar flexion (0.670), ulnar deviation (0.441), radial deviation (1.000), supination (0.132), or pronation (0.302). Quick Disabilities of the Arm, Shoulder and Hand score did not differ by >95% between the groups over the analysis period. Conclusion:It was observed that alendronate administration in distal radius fractures did not appear to delay fracture healing times radiologically or clinically.

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Effect of Alendronic Acid on Fracture Healing: A Multicenter Randomized Placebo-Controlled Trial

Duckworth

McQueen

Tuck

et al. 2019

Journal of Bone and Mineral Research

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There is a concern that bisphosphonates may impair fracture healing because of their inhibitory effects on bone turnover. Here we evaluated the effects of early bisphosphonate therapy on fracture healing and functional outcome following a fracture of the distal radius. The fracture and bisphosphonates (FAB) trial was a double-blind, randomized, placebo-controlled trial involving 15 trauma centers in the United Kingdom. We enrolled 421 bisphosphonate-naive patients aged !50 years with a radiographically confirmed fracture of the distal radius and randomized them in a 1:1 ratio to receive alendronic acid 70 mg once weekly (n ¼ 215) or placebo (n ¼ 206) within 14 days of the fracture. The primary outcome measure was the proportion of fractures that had radiologically united at 4 weeks as assessed by an observer, blinded to treatment allocation. Secondary outcomes included the Disabilities of the Arm Shoulder and Hand (DASH) questionnaire, range of wrist movement and grip strength, pain and analgesia requirements, and the rate of malunion. The mean AE SD age of participants was 63 AE 8.5 years and 362 (86%) were female. At 4 weeks, 48 of 202 (23.8%) fractures had united in the alendronic acid group compared with 52 of 187 (27.8%) in the placebo group (observed absolute proportion difference 4.0%; 95% CI, -4.7% to 12.8%; p ¼ 0.36). The absolute proportion difference between groups based on imputed data was 4.5% (95% CI, -4.7% to 13.8%; p ¼ 0.30). There was no significant difference in the proportion of fractures that had united at any other time point and no differences in the DASH score, pain at the fracture site, grip strength, or any other clinical outcome. We conclude that among patients aged 50 years and above with a distal radius

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Effect of early administration of alendronate after surgery for distal radial fragility fracture on radiological fracture healing time

Cited by 31 publications

References 41 publications

Timing of the initiation of bisphosphonates after surgery for fracture healing: a systematic review and meta-analysis of randomized controlled trials

Timing of the initiation of bisphosphonates after surgery for fracture healing: a systematic review and meta-analysis of randomized controlled trials

Effect of Alendronate on the Healing Time of Distal Radial Fractures Treated Conservatively: An Observational Study

Effect of Alendronic Acid on Fracture Healing: A Multicenter Randomized Placebo-Controlled Trial

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