Oral Bisphosphonates and Risk of Subtrochanteric or Diaphyseal Femur Fractures in a Population-Based Cohort
2011

Oral Bisphosphonates and Femur Fracture Risk

Sample size: 33815 publication Evidence: moderate

Author Information

Author(s): Kim Seo Young, Schneeweiss Sebastian, Katz Jeffrey N, Levin Raisa, Solomon Daniel H

Primary Institution: Brigham and Women's Hospital

Hypothesis

Does long-term use of oral bisphosphonates increase the risk of subtrochanteric or diaphyseal femur fractures compared to raloxifene or calcitonin?

Conclusion

There is no significant difference in the risk of subtrochanteric or diaphyseal femur fractures between users of oral bisphosphonates and those using raloxifene or calcitonin.

Supporting Evidence

  • The estimated incidence rate of fractures was similar between bisphosphonate users and those using raloxifene or calcitonin.
  • Only 104 fractures were observed among 33,815 patients in the study.
  • The hazard ratio for bisphosphonate use was 1.03, indicating no significant increase in fracture risk.

Takeaway

This study looked at whether taking certain osteoporosis medications increases the chance of breaking a specific part of the thigh bone. It found that there isn't a big difference in fracture risk between the medications.

Methodology

A propensity score-matched cohort study using health care utilization data to compare fracture rates among users of oral bisphosphonates and those using raloxifene or calcitonin.

Potential Biases

Potential for confounding bias due to non-random allocation of treatments.

Limitations

The study could not assess whether all fractures had characteristic radiographic findings of atypical fractures, and there may be residual confounding due to unmeasured factors.

Participant Demographics

Mean age of participants was approximately 80 years, with 97% being women and 95% white.

Statistical Information

P-Value

1.03

Confidence Interval

95% CI 0.70–1.52

Statistical Significance

p>0.05

Digital Object Identifier (DOI)

10.1002/jbmr.288

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