Bisphosphonate discontinuation was associated with a rapid decrease in the risk of atypical fracture.
Whites, 4.84 95% CI, 3.57 to 6.56), height, weight, and glucocorticoid use.
Other risk factors included race (hazard ratio for Asians vs. After multivariable adjustment, the risk of atypical fracture increased with longer duration of bisphosphonate use: the hazard ratio as compared with less than 3 months increased from 8.86 (95% confidence interval, 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. ResultsĪmong 196,129 women, 277 atypical femur fractures occurred. The risk–benefit profile was modeled for 1 to 10 years of bisphosphonate use to compare associated atypical fractures with other fractures prevented. Fractures were radiographically adjudicated. Data on risk factors, including bisphosphonate use, were obtained from electronic health records. The primary outcome was atypical femur fracture. We studied women 50 years of age or older who were receiving bisphosphonates and who were enrolled in the Kaiser Permanente Southern California health care system women were followed from January 1, 2007, to November 30, 2017. Important uncertainties remain regarding the association between atypical femur fractures and bisphosphonates and other risk factors. However, concerns about atypical femur fractures have contributed to substantially decreased bisphosphonate use, and the incidence of hip fractures may be increasing. The most trusted, influential source of new medical knowledge and clinical best practices in the world.īisphosphonates are effective in reducing hip and osteoporotic fractures.
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