Oral bisphosphonates are associated with increased risk of subtrochanteric and diaphyseal fractures in elderly women: a nested case–control study

Erviti, Juan; Alonso, Álvaro; Oliva, Belén; Gorricho, Javier; López, Antonio; Timoner, Julia; Huerta, Consuelo; Gil, Miguel; Abajo, Francisco de

doi:10.1136/bmjopen-2012-002091

Cited by 53 publications

(36 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Clinically, the loss of bone turnover and subsequent increased risk of femur fracture have been noted in prolonged bisphosphonate users and in younger, more active patients as atypical femur fractures [11,13]. As such patients comprised a small group in our study, and our estimations had a great deal of uncertainty (wide CIs); further investigation is warranted.…”

Section: Discussionmentioning

confidence: 91%

“…Bisphosphonates are known to accumulate in the bone and have effects for years [11], leading to lack of bone turnover through osteoclastic and osteoblastic activity inhibition [20]. Clinically, the loss of bone turnover and subsequent increased risk of femur fracture have been noted in prolonged bisphosphonate users and in younger, more active patients as atypical femur fractures [11,13].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Association of Bisphosphonate Use and Risk of Revision After THA: Outcomes From a US Total Joint Replacement Registry

Khatod

Inacio

Dell

et al. 2015

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Total hip arthroplasty (THA) is often performed in patients who are older and may take bisphosphonates to treat a variety of conditions, most commonly osteoporosis. However, the clinical effects of bisphosphonate use on patients who have undergone THA are not well described. Questions/purposes (1) Is bisphosphonate use in patients with osteoarthritis undergoing primary THA associated with a change in the risk of all-cause revision, aseptic revision, or periprosthetic fracture compared with patients not treated with bisphosphonates? (2) Does the risk of bisphosphonate use and revision and periprosthetic fracture vary by patient bone mineral density and age? Methods A retrospective cohort study of 12,878 THA recipients for the diagnosis of osteoarthritis was conducted; 17.8% of patients were bisphosphonate users. Data sources for this study included a joint replacement registry (93% voluntary participation) and electronic health records and an osteoporosis screening database with complete capture of cases as part of the Kaiser Permanente integrated healthcare system. The endpoints for this study were revision surgery for any cause, aseptic revision, and periprosthetic fracture. The exposure of interest was bisphosphonate use; patients were considered users if prescriptions were continuously refilled for a period equal to or longer than 6 months. Bone quality (based on dual-energy x-ray absorptiometery ordered based on the National Osteoporosis Foundation's clinical guidelines taken within 5 years of the THA) and patient age (\ 65 versus C 65 years) were evaluated as effect modifiers. Patient, surgeon, and hospital factors were evaluated as confounders. Cox proportional hazards models were used. Hazard ratios (HRs) and 95% confidence intervals (CIs) were determined. Results Age-and sex-adjusted risks of all-cause (HR, 0.50; 95% CI, 0.33-0.74; p \ 0.001) and aseptic revision Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. Clinical Orthopaedics and Related Research 1 neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDAapproval status, of any drug or device prior to clinical use. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. HR, 0.53; 95% CI,; p = 0.004) was lower in bisphosphonate users than in nonusers. The adjusted risk of periprosthetic fractures in patients o...

show abstract

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Association of Bisphosphonate Use and Risk of Revision After THA: Outcomes From a US Total Joint Replacement Registry

Khatod

Inacio

Dell

et al. 2015

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…First, we handled missing values of other variable.-While the missing data was continuous variable, we supplemented with the mean or median. When it was categorical variable, we treated this variable as a categorical variable [14].…”

Section: Discussionmentioning

confidence: 99%

Association of Triglyceride to high-density lipoprotein cholesterol ratio and incident of diabetes mellitus: a secondary retrospective analysis based on a Chinese cohort study

Chen

et al. 2020

Lipids Health Dis

View full text Add to dashboard Cite

Background: Previous studies have revealed that triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) is one of major risk factors of insulin resistance and diabetes. However, study on the association between TG/ HDL-C and diabetes mellitus (DM) risk is limited, especially in Chinese people. This study was undertaken to investigate the relationship between TG/HDL-C and incident of diabetes in a large cohort in Chinese population. Methods: The present study was a retrospective cohort study. A total of 114,787 adults from Rich Healthcare Group in China, which includes all medical records for participants who received a health check from 2010 to 2016. The target independent variable and the dependent variable were triglyceride to high-density lipoprotein cholesterol ratio measured at baseline and incident of diabetes mellitus appeared during follow-up respectively. Covariates involved in this study included age, gender, body mass index, diastolic blood pressure, systolic blood pressure, fasting plasma glucose, total cholesterol, low density lipoprotein cholesterol, serum creatinine, smoking and drinking status and family history of diabetes. Cox proportional-hazards regression was used to investigate the association of TG/HDL-C and diabetes. Generalized additive models was used to identify non-linear relationships. Additionally, we also performed a subgroup analysis. It was stated that the data had been uploaded to the DATADRYAD website.(Continued on next page) Result: After adjusting age, gender, body mass index, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, low density lipoprotein cholesterol, serum creatinine, smoking and drinking status and family history of diabetes, result showed TG/HDL-C was positively associated with incident of diabetes mellitus (HR = 1.159, 95%CI (1.104, 1.215)). A non-linear relationship was detected between TG/HDL-C and incident of diabetes, which had an inflection point of TG/HDL-C was 1.186. The effect sizes and the confidence intervals on the left and right sides of the inflection point were 1.718(1.433,2.060) and 1.049(0.981,1.120), respectively. Subgroup analysis showed, the stronger association can be found in the population with fasting plasma glucose (FPG) < 6.1 mmol/L (P for interaction< 0.0001; HR = 1.296 with FPG < 6.1 mmol/L vs HR = 1.051 with FPG ≥ 6.1 mmol/L).The same trend was also seen in the population with body mass index (BMI)(≥18.5, < 24 kg/m 2 ) (P for interaction = 0.010,HR = 1.324) and family history without diabetes(P for interaction = 0.025, HR = 1.170).Conclusion: TG/HDL-C is positively associated with diabetes risk. The relationship between TG/HDL-C and incident of diabetes is also non-linear. TG/HDL-C was strong positively related to incident of diabetes when TG/HDL-C is less than 1.186.

show abstract

“…Nesta vertente, os nossos resultados são apoiados pela literatura com resultados de odds ratio de 9,46 em doentes com tratamento superior a três anos (Erviti et al) 15 ; 66,9 em doentes com uma mediana de duração de tratamento no grupo entre os 5-9 anos (Meier et al) 5 ; e 1000 em doentes com tratamento médio de 7,1 anos (Isaacs et al), 6 resultados estes também estatisticamente significativos e com intervalos de confiança de 95%.…”

Section: Discussionunclassified

Fracturas Femorais Atípicas e o Tratamento com Bifosfonatos: É um Factor de Risco?

Geada

Mafra²,

Barroso³

et al. 2014

Acta Med Port

View full text Add to dashboard Cite

Introduction:Bisphosphonates are effective in preventing osteoporotic fracture, however atypical femoral fractures with a well-defined radiological pattern have been described in association with prolonged treatment with bisphosphonates. Our objectives in this study were to characterize patients ≥ 65 years old with femoral fractures (subtrochanteric/diaphyseal) considered typical and atypical and the relationship between the occurrence of atypical fractures and bisphosphonate use. Material and Methods:We conducted a case-control study with patients admitted in our hospital with subtrochanteric or diaphyseal femur fracture in a period of five and a half years. After applying the exclusion criteria, the 92 fractures (91 patients) were classified as typical or atypical. The determination of prior bisphosphonate treatment was obtained through consultation of the individual medical history. Results: We found 11 atypical fractures (10 patients) and 81 typical fractures (81 patients). The median age of both groups was statistically different (72 years -atypical vs. 80 years -typical, p < 0.01). The reason for the use of bisphosphonates was 0.60 in atypical fractures and 0.01 in typical, and an odds ratio of 101.1 was obtained (p < 0.01). Discussion: Our results are supported and are in agreement with published studies relating to the occurrence of atypical femoral fractures associated with treatment with bisphosphonates. Conclusion:Despite the small number of cases it was possible to demonstrate a statistically significant relation between atypical femoral fractures and treatment with bisphosphonates. One should note that these atypical fractures occurred in patients significantly younger than patients with typical fractures.

show abstract

Oral bisphosphonates are associated with increased risk of subtrochanteric and diaphyseal fractures in elderly women: a nested case–control study

Cited by 53 publications

References 21 publications

Association of Bisphosphonate Use and Risk of Revision After THA: Outcomes From a US Total Joint Replacement Registry

Association of Bisphosphonate Use and Risk of Revision After THA: Outcomes From a US Total Joint Replacement Registry

Association of Triglyceride to high-density lipoprotein cholesterol ratio and incident of diabetes mellitus: a secondary retrospective analysis based on a Chinese cohort study

Fracturas Femorais Atípicas e o Tratamento com Bifosfonatos: É um Factor de Risco?

Contact Info

Product

Resources

About