Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Bisphosphonate Drug Holidays and Fracture Risk

Endocr Pract; 2018 Feb; Bindon, Adams, et al

Patients who begin bisphosphonate (BP) drug holidays—and who are at high risk of fracture based on bone mineral density (BMD), age, or other clinical risk factors—warrant close follow-up, according to a recent study, especially as its duration lengthens. Fracture risk analysis needs to be regularly assessed during the drug holiday and treatment resumed accordingly. A retrospective chart review was conducted of 401 patients with osteopenia or osteoporosis who began a BP drug holiday from 2004 to 2013. Collected parameters included demographics, prior therapy, BMD, bone turnover markers, parathyroid hormone, calcium and vitamin D status, and clinical reports of fractures. Researchers found:

  • 62 (15.4%) patients developed a fracture during follow-up.
  • The yearly incidence of fractures ranged from 3.7 to 9.9%, peaking at 9.9% and 9.8% during years 4 and 5, respectively.
  • The mean age of the fracture group was higher than the nonfracture group, though not significantly different (69.24 ± 12.26 years vs 66.42 ± 10.18 years).
  • Compared to the nonfracture group, the fracture group had lower femoral neck BMD and T-scores at baseline.

Citation:

Bindon B, Adams W, Balasubramanian N, Sandhu J, Camacho P. Osteoporotic fractures during bisphosphonate drug holiday. Endocr Pract. 2018;24(2):163-169. doi:10.4158/EP171975.OR.

This Week's Must Reads

Leukemia risk after maternal contraception use, Hargreave M et al. Lancet Oncol. 2018 Sep 6. doi: 10.1016/S1470-2045(18)30479-0

BP Treatment Assessed Among Persons with Diabetes, Diabetes Care; ePub 2018 Aug 27; Muntner, et al

Attendance Is Key in Weight Loss Management Program, Obesity; ePub 2018 Aug 29; Kumanyika, et al

Very Low LDL-C Linked with Type 2 Diabetes, PLoS Med; ePub 2018 Aug 28; Feng, et al

Abdominal Muscle Composition, Diabetes Link Studied, Diabetes Obes Metab; ePub 2018 Aug 29; Granados, et al

Must Reads in Osteoporosis

Markers of Bone Turnover, Diabetes Examined, Diabetes Care; ePub 2018 Jul 12; Massera, et al

Bisphosphonate Drug Holidays and Fracture Risk, Endocr Pract; 2018 Feb; Bindon, Adams, et al

ACP Updates Osteoporosis Guideline, Ann Intern Med; ePub 2017 May 9; Qaseem, et al

FDA Approves Tymlos to Treat Osteoporosis, Radius news release; 2017 Apr 28

This Group Is Not Adhering to Screening Guidelines, Am J Med; 2017 Mar; Gillespie, Morin