
This article was published in Dynamic Chiropractic June 17, 2010 (Vol. 28, issue 13) and is presented here for review.
By Deborah Pate, DC, DACBR
There has been a flurry of reports recently on the association of atypical femoral fractures with long-term treatment with bisphosphonates. Several studies have reported the occurrence of specific and rare types of femur fractures in individuals (mostly women) who had been taking bisphosphonates, specifically alendronate (Fosamax), for approximately 4-8 years.1-9 It should be noted that the fractures occurred with no apparent trauma.
These fractures were not from falls. In fact, in most cases, individuals were performing low-energy exercise, sometimes just walking down a flight of stairs.10-11
Bisphosphonates such as alendronate, risendronate and ibandronate are inhibitors of bone resorption. Extensive studies have shown that therapy with bisphosphonates improves bone density and decreases fracture risk. These drugs, especially the oldest one, alendronate, are used by large numbers of postmenopausal women, as well as smaller numbers of men with osteoporosis. In 2008, bisphosphonate sales exceeded $3.5 billion, according to data from IMS Health.
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