Bifosfonat kullanımına bağlı femur cisim kırıkları

Öz

Çalışma planı: Düşük enerjili eklem dışı femur kırığı olan ve entegre bir sağlık sistemi içinde tedavi edilen 55 yaşın üzerinde 106 hastanın elektronik kayıtları incelendi. Hastalar prospektif bir veritabanı üzerinden saptandı ve tüm kırıklar anatomik olarak sınıflandırıldı. Olgular kırığı olmayan kontrol grubu ile eşleştirilerek, reçeteler ilaca maruz kalma durumunu değerlendirmek için incelendi. Koşullu lojistik regresyon analizi ile bifosfonata maruz kalma ile kırık arasında anlamlı bir ilişki olup olmadığına bakıldı. Bulgular: Yüz altı olgunun 13’ü (%12) ve 804 kontrolün 76’sı (%9) kırık öncesinde en az bir yıl boyunca bisfosfonat kullanmıştı. Bir risk faktörü olarak bifosfonata maruz kalma olasılık oranının 1.52 (%95 güven aralığı: 0.76-3.05) olarak belirlenmesi istatistiksel olarak anlamlı bir ilişki olmadığını düşündürdü (p=0.24). Dört yıllık maruz kalma durumu ya da sadece alendronatlar incelendiği zaman benzer bulgular elde edildi. Çıkarımlar: Bu olgu-kontrol çalışmasında, bifosfonata maruz kalmanın eklem dışı femur kırığı ile ilişkisi saptanmadı. Biz düşük enerjili, geriatrik femur kırıklarının çoğunluğunun bifosfonata maruz kalma ile ilişkili olmadığını düşünüyoruz.

Anahtar Kelimeler

• Alendronat; bifosfonat; femur cisim; osteoporoz; yetersizlik kırığı

Diaphyseal femur fractures associated with bisphosphonate use

Abstract

Objective: The aim of this study was to investigate the association of bisphosphonate exposure with low-energy, non-articular femur fractures.
Methods: The electronic records of 106 patients over the age of 55 years who sustained low-energy non-articular femur fractures and were treated within an integrated health system were examined. Patients were identified through a prospective registry and all fractures were classified anatomically. Cases were matched with control patients without fracture, and prescription orders were examined to assess drug exposures. Conditional logistic regression tested for a significant association between bisphosphonate exposure and fracture.
Results: Thirteen of the 106 cases (12%) and 76 of 804 controls (9%) received at least one year of prescriptions for bisphosphonates prior to fracture. Odds ratio for bisphosphonate exposure as a risk factor was 1.52 (95% confidence interval: 0.76 to 3.05), suggesting no statistically significant association (p=0.24). Results were similar when four-year exposure or alendronates only were studied.
Conclusion: Bisphosphonate exposure was not associated with non-articular femur fracture in this case-control study. We suggest that the majority of low-energy, geriatric femur fractures are not associated with bisphosphonate exposure.

Keywords

• Alendronate
• bisphosphonate
• femur diaphysis
• insufficiency fracture
• osteoporosis

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