Can long-term bisphosphonate use causes low-energy fractures? A case report

Bisphosphonates are inorganic pyrophosphate analog which accumulate on the bone surface, cause osteoclast apoptosis, and inhibit bone resorption. The nitrogen-containing bisphosphonates continue to be the drug of choice for the treatment of osteoporosis in both men and women. Although histomorphomet...

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Bibliographic Details
Published in:Osteoporosis international 2014-02, Vol.25 (2), p.773-776
Main Authors: Dandinoğlu, T., Akarsu, S., Karadeniz, M., Tekin, L., Arıbal, S., Kıralp, M. Z.
Format: Article
Language:English
Subjects:
Aged
Bone Density Conservation Agents - administration & dosage
Bone Density Conservation Agents - adverse effects
Bone Density Conservation Agents - therapeutic use
Case Report
Diphosphonates - administration & dosage
Diphosphonates - adverse effects
Diphosphonates - therapeutic use
Drug Administration Schedule
Drug therapy
Endocrinology
Female
Femoral Fractures - chemically induced
Femoral Fractures - diagnostic imaging
Fractures
Fractures, Spontaneous - chemically induced
Fractures, Spontaneous - diagnostic imaging
Humans
Humeral Fractures - chemically induced
Humeral Fractures - diagnostic imaging
Medicine
Medicine & Public Health
Orthopedics
Osteoporosis
Osteoporosis, Postmenopausal - drug therapy
Radiography
Rheumatology
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Summary:Bisphosphonates are inorganic pyrophosphate analog which accumulate on the bone surface, cause osteoclast apoptosis, and inhibit bone resorption. The nitrogen-containing bisphosphonates continue to be the drug of choice for the treatment of osteoporosis in both men and women. Although histomorphometric studies including bone biopsies have not shown any evidence of microcracks, recent studies have revealed that potent bisphosphonates are responsible for the oversuppression of bone turnover leading to microdamages, reduced bone strength, and increased fracture risk. There are individual cases reporting atypical femoral fractures and severely suppressed bone turnover along with long-term (≥5 years) use of biphosphonates. In this study, we report on a 74-year-old woman with a history of continuous alendronate use for nearly 16 years who presented to the emergency department with right proximal humerus and left femur fracture.
ISSN:0937-941X
1433-2965
DOI:10.1007/s00198-013-2428-0