Atypical Femur Fracture Risk versus Fragility Fracture Prevention with Bisphosphonates

Study (n=196,129) found risk of atypical femur fracture increased with longer duration of bisphosphonate (BP) use & rapidly decreased after discontinuation. Absolute risk, however, remained very low as compared with reductions in risk of hip and other fractures with BP treatment.

SPS commentary:

In the study, 277 atypical femur fractures occurred. Asians had a higher risk than Whites. The hazard ratio as compared with less than 3 months increased from 8.86 (95% CI, 2.79 to 28.20) for 3 years to less than 5 years to 43.51 (95% CI, 13.70 to 138.15) for 8 years or more


New England Journal of Medicine