How do bisphosphonates affect fracture healing?

Kates, Stephen L.; Ackert‐Bicknell, Cheryl

doi:10.1016/s0020-1383(16)30015-8

Cited by 96 publications

(68 citation statements)

References 35 publications

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“…Another group of drugs used prior to the development of denosumab for both primary and secondary osteoporosis was bisphosphonates. Bisphosphonates are concentrated directly in bone and can enter the osteoclast where it causes an acidic medium in lacunae after activation [31]. Once internalized, they are toxic for the osteoclast.…”

Section: Mechanism Of Action Of Denosumab and Bisphosphonatesmentioning

confidence: 99%

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Comparing the Efficacy and Safety of Denosumab with Bisphosphonates in Increasing Bone Mineral Density in Patients with Prostate Cancer and Breast Cancer on Antihormonal Treatment

Razaq¹,

Khan

Hassan

et al. 2019

Cureus

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Osteoporosis is a common condition prevalent in both sexes that can be primary and secondary. Secondary osteoporosis may occur in cancer patients undergoing antihormonal treatment, leading to an increased risk of fractures. Androgen deprivation therapy (ADT) in patients with prostate cancer and aromatase inhibitors (AI) in patients with breast cancer can drastically increase the risk of osteoporosis. Bisphosphonates are one of the key medications in managing these patients and are widely prescribed. A monoclonal antibody called denosumab, which is a relatively new treatment option, is also used in this population group. To conduct a detailed comparison of these groups, we performed a thorough literature search using Pubmed and Google Scholar to extract data in the form of research papers/clinical trials. A total of 18 research papers were extracted using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and other inclusion and exclusion criteria. Seven of these papers were based on randomized controlled trials (RCTs) comparing denosumab with either placebo or bisphosphonates in patients with breast cancer and prostate cancer. Two metaanalyses comparing the safety and efficacy of both these drugs in this population group were also included. Denosumab was found to significantly increase bone mineral density (BMD) for up to two years and showed better results than bisphosphonates, while both had a comparable safety profile. More trials should be conducted in patients with prostate cancer or breast cancer on ADT or AI therapy, respectively, for longer durations to assess the long-term safety of these drugs in this population.

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Section: Mechanism Of Action Of Denosumab and Bisphosphonatesmentioning

confidence: 99%

“…They either inactivate or trigger apoptosis of the osteoclast depending on whether they are nitrogenous or non-nitrogenous bisphosphonates. They either cause apoptosis directly or inhibit the enzyme farnesyl pyrophosphate synthase [31].…”

Section: Mechanism Of Action Of Denosumab and Bisphosphonatesmentioning

confidence: 99%

Comparing the Efficacy and Safety of Denosumab with Bisphosphonates in Increasing Bone Mineral Density in Patients with Prostate Cancer and Breast Cancer on Antihormonal Treatment

Razaq¹,

Khan

Hassan

et al. 2019

Cureus

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“…pamidronate, alendronate, ibandronate, risedronate and zoledronate). All BPs have a high affinity for calcium and in the body they concentrate in the skeleton at sites of active bone remodeling preventing fractures in osteoporotic patients and reduce the risk of fracture by up to 50% [38,39] .…”

Section: Bisphosphonatesmentioning

confidence: 99%

A Review on Glucocorticoids Induced Osteoporosis: Pathogenesis, Diagnosis and Management by Some Natural Plants

Khaliefa¹,

El-Desouky²,

Hozayen³

et al. 2016

IJFNS

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200 million person all over the world affected by osteoporosis as it is most common metabolic bone disorder. The general reason of bone loss are age and menopause, and the rates of bone loss variable between individuals. Physical activity and environmental factors as nutrition can contribute to bone health as they modify both peak bone mass and following bone loss. Medications embrace both antiresorptive and anabolic types. Antiresorptive medications acts by reducing rates of bone remodeling like estrogens, selective estrogen receptor modulators (raloxifene), bisphosphonates (alendronate, risedronate, and ibandronate) and calcitonins. Parathyroid hormone is the only anabolic medication. The nonmedical treatment must be used with pharmacologic treatment to maximize outcomes for osteoporotic patient. Some plant-derived natural products, mostly phytoestrogens (isoflavones, lignans, coumestanes, stilbenes) and many more novel estrogen-like compounds in plants have been greatly used to prevent depletion in bone mineral density. In this review an attempt has been made out to compile the mechanisms of glucocorticoids induced osteoporosis, the medicinal plants which are commonly utilized in osteoporosis with their prominent chemical ingredients and certain pharmacological actions.

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“…The common notion that atypical fractures are associated with a high risk of perioperative complications and a higher risk of delayed healing or non-union as well as consequential reoperations might have reinforced those fears [3][4][5][6][7][8]. The perception of a poor healing capacity is based on case reports [9,10] and case series [5,6,[11][12][13], which contrast results from animal and human studies showing no negative impact of bisphosphonates on fracture healing, except for callus remodeling [14,15]. In long-term bisphosphonate exposure, the severe suppression of bone turnover has been suggested to decrease the anabolic response of Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00198-019-05249-3) contains supplementary material, which is available to authorized users.…”

Section: Introductionmentioning

confidence: 99%

Increased rate of reoperation in atypical femoral fractures is related to patient characteristics and not fracture type. A nationwide cohort study

et al. 2020

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Atypical femoral fractures are burdened with a high rate of reoperation. In our nationwide analysis, the increased rate of reoperation was related to patient background characteristics, such as age and health status, rather than fracture type. Introduction Patients with atypical fractures are complex to treat and burdened with a high risk of reoperation. We hypothesized that patients with surgically treated, complete atypical fractures have a higher risk of any reoperation and reoperation related to healing complications than patients with common femoral shaft fractures but that this increase would become insignificant when adjusted for predefined characteristics. Methods A cohort of 163 patients with atypical fractures and 862 patients with common femoral shaft or subtrochanteric fractures treated from 2008 to 2010 and who had follow-up radiographs and register data available until 31 December 2014 was included. Reoperations were identified by a complementary review of radiographs and register data and were used to calculate risks for any reoperation and reoperations related to healing complications. Results Patients with atypical fractures were more likely to be reoperated for any reason, age-adjusted OR 1.76 (95% CI, 1.08 to 2.86). However, patients with common fractures had a shorter follow-up due to a threefold higher death rate. Accordingly, in a multivariable-adjusted time-to-event model, the increased risk lost statistical significance for any reoperations, cause-specific HR 1.34 (95% CI, 0.85 to 2.13), and for reoperations related to healing complications, HR 1.32 (95% CI, 0.58 to 3.0). Continued use of bisphosphonate in the first year after the fracture did not affect the reoperation rate. Conclusions Our findings suggest that the increased risk of reoperation after an atypical femur fracture is largely explained by patient characteristics and not fracture type.

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How do bisphosphonates affect fracture healing?

Cited by 96 publications

References 35 publications

Comparing the Efficacy and Safety of Denosumab with Bisphosphonates in Increasing Bone Mineral Density in Patients with Prostate Cancer and Breast Cancer on Antihormonal Treatment

Comparing the Efficacy and Safety of Denosumab with Bisphosphonates in Increasing Bone Mineral Density in Patients with Prostate Cancer and Breast Cancer on Antihormonal Treatment

A Review on Glucocorticoids Induced Osteoporosis: Pathogenesis, Diagnosis and Management by Some Natural Plants

Increased rate of reoperation in atypical femoral fractures is related to patient characteristics and not fracture type. A nationwide cohort study

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