Association of low-energy femoral fractures with prolonged bisphosphonate use: a case control study.
Association of low-energy femoral fractures with prolonged bisphosphonate use: a case control study.
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DOI：
10.1007/s00198-008-0805-x
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发表时间：
2009-08
影响因子：
4
通讯作者：
Lane, J. M.
中科院分区：
文献类型：
--
作者：
Lenart, B. A.;Neviaser, A. S.;Lyman, S.;Chang, C. C.;Edobor-Osula, F.;Steele, B.;van der Meulen, M. C. H.;Lorich, D. G.;Lane, J. M.
最近的证据表明，长期使用双磷酸盐与绝经后妇女股骨功能不全骨折有关。在这项病例对照研究中，我们确定了独特的股骨干骨折、皮质增厚区域的横向骨折和长期服用双膦酸类药物之间的显著关联。有必要进行进一步的研究。虽然临床试验证实了双膦酸盐在3-5年内的抗骨折效果，但双膦酸盐对骨代谢的长期影响尚不清楚。已有长期治疗患者发生股骨功能不全骨折的报道。我们对2000-2007年间出现低能量股骨骨折的绝经后妇女进行了一项回顾性病例对照研究。41例股骨粗隆下和股骨干骨折病例被确定，并根据年龄、种族和体重指数与股骨粗隆间和股骨颈骨折各1例相匹配。41例患者中有15例使用了双磷酸盐，而82例股骨粗隆间/股骨颈对照组中有9例使用了双膦酸类药物(Mantel-Haenszel优势比(OR)为4.44[95%可信区间(CI)1.77~11.35]；P=0.002)。在15例股骨转子下/骨干病例中，有10例在双磷酸盐上发现了共同的X线片。这种X光片模式与双膦酸盐的使用高度相关(OR，15.33[95%CI3.0676.90]；P<；0.001)。与两组髋部骨折对照组相比，股骨转子下/骨干组使用双磷酸盐的时间更长(P=0.001)。我们发现，与粗隆间/股骨颈骨折相比，转子下/骨干骨折患者长期服用双磷酸盐的比例明显更高。双膦酸盐的使用与一种独特的X射线模式高度相关。有必要进行进一步的研究。
Recent evidence has linked long-term bisphosphonate use with insufficiency fractures of the femur in postmenopausal women. In this case–control study, we have identified a significant association between a unique fracture of the femoral shaft, a transverse fracture in an area of thickened cortices, and long-term bisphosphonate use. Further studies are warranted. Although clinical trials confirm the anti-fracture efficacy of bisphosphonates over 3–5 years, the long-term effects of bisphosphonate use on bone metabolism are unknown. Femoral insufficiency factures in patients on prolonged treatment have been reported. We performed a retrospective case–control study of postmenopausal women who presented with low-energy femoral fractures from 2000 to 2007. Forty-one subtrochanteric and femoral shaft fracture cases were identified and matched by age, race, and body mass index to one intertrochanteric and femoral neck fracture each. Bisphosphonate use was observed in 15 of the 41 subtrochanteric/shaft cases, compared to nine of the 82 intertrochanteric/femoral neck controls (Mantel–Haenszel odds ratio (OR), 4.44 [95% confidence interval (CI) 1.77–11.35]; P=0.002). A common X-ray pattern was identified in ten of the 15 subtrochanteric/shaft cases on a bisphosphonate. This X-ray pattern was highly associated with bisphosphonate use (OR, 15.33 [95% CI 3.06–76.90]; P< 0.001). Duration of bisphosphonate use was longer in subtrochanteric/shaft cases compared to both hip fracture controls groups (P=0.001). We found a significantly greater proportion of patients with subtrochanteric/shaft fractures to be on long-term bisphosphonates than intertrochanteric/femoral neck fractures. Bisphosphonate use was highly associated with a unique X-ray pattern. Further studies are warranted.
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影响因子：
158.5
作者：
Lyles, Kenneth W.;Colon-Emeric, Cathleen S.;Boonen, Steven
通讯作者：
Boonen, Steven
影响因子：
158.5
作者：
LIBERMAN, UA;WEISS, SR;KARPF, DB
通讯作者：
KARPF, DB
影响因子：
15.9
作者：
Plotkin, LI;Weinstein, RS;Bellido, T
通讯作者：
Bellido, T
影响因子：
158.5
作者：
Bone, HG;Hosking, D;Liberman, UA
通讯作者：
Liberman, UA
影响因子：
4.1
作者：
Mashiba, T;Turner, CH;Burr, DB
通讯作者：
Burr, DB