Araştırma Makalesi
BibTex RIS Kaynak Göster

Bifosfonat kullanımına bağlı femur cisim kırıkları

Yıl 2013, Cilt: 47 Sayı: 4, 255 - 260, 18.09.2013

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.

Kaynakça

  • Lenart BA, Lorich DG, Lane JM. Atypical fractures of the femoral diaphysis in postmenopausal women taking alen- dronate. N Engl J Med 2008;358:1304-6.
  • Neviaser AS, Lane JM, Lenart BA, Edobor-Osula F, Lorich DG. Low-energy femoral shaft fractures associated with alendronate use. J Orthop Trauma 2008;22:346-50.
  • Visekruna M, Wilson D, McKiernan FE. Severely sup- pressed bone turnover and atypical skeletal fragility. J Clin Endocrinol Metab 2008;93:2948-52.
  • Odvina CV, Zerwekh JE, Rao DS, Maalouf N, Gottschalk FA, Pak CY. Severely suppressed bone turnover: a potential com- plication of alendronate therapy. J Clin Endocrinol Metab 2005;90:1294-301.
  • Goh SK, Yang KY, Koh JS, Wong MK, Chua SY, Chua DT, et al. Subtrochanteric insufficiency fractures in patients on alendronate therapy: a caution. J Bone Joint Surg Br 2007; 89:349-53.
  • Armamento-Villareal R, Napoli N, Diemer K, Watkins M, Civitelli R, Teitelbaum S, et al. Bone turnover in bone biop- sies of patients with low-energy cortical fractures receiving bisphosphonates: a case series. Calcif Tissue Int 2009;85:37- 44.
  • Cheung RK, Leung KK, Lee KC, Chow TC. Sequential non-traumatic femoral shaft fractures in a patient on long- term alendronate. Hong Kong Med J 2007;13:485-9.
  • Armamento-Villareal R, Napoli N, Panwar V, Novack D. Suppressed bone turnover during alendronate therapy for high-turnover osteoporosis. N Engl J Med 2006;355:2048- 50.
  • Capeci CM, Tejwani NC. Bilateral low-energy simultaneous or sequential femoral fractures in patients on long-term alendronate therapy. J Bone Joint Surg Am 2009;91:2556- 61.
  • Kwek EB, Goh SK, Koh JS, Png MA, Howe TS. An emerg- ing pattern of subtrochanteric stress fractures: a long-term complication of alendronate therapy? Injury 2008;39:224- 31.
  • Ing-Lorenzini K, Desmeules J, Plachta O, Suva D, Dayer P, Peter R. Low-energy femoral fractures associated with the long-term use of bisphosphonates: a case series from a Swiss university hospital. Drug Saf 2009;32:775-85.
  • Isaacs JD, Shidiak L, Harris IA, Szomor ZL. Femoral insuf- ficiency fractures associated with prolonged bisphosphonate therapy. Clin Orthop Relat Res 2010;468:3384-92.
  • Shane E, Burr D, Ebeling PR, Abrahamsen B, Adler RA, Brown TD, et al; American Society for Bone and Mineral Research. Atypical subtrochanteric and diaphyseal femoral fractures: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res 2010;25: 2267-94.
  • Possible increased risk of thigh bone fracture with bisphos- phonates [Internet]. Food and Drug Administration (FDA) [cited 2010 Jan 26]. Available from: http://www.fda.gov/ NewsEvents/Newsroom/PressAnnouncements/ucm229171. htm.
  • Abrahamsen B, Eiken P, Eastell R. Subtrochanteric and dia- physeal femur fractures in patients treated with alendronate: a register-based national cohort study. J Bone Miner Res 2009;24:1095-102.
  • Black DM, Kelly MP, Genant HK, Palermo L, Eastell R, Bucci-Rechtweg C, et al; Fracture Intervention Trial Steering Committee; HORIZON Pivotal Fracture Trial Steering Committee. Bisphosphonates and fractures of the subtrochanteric or diaphyseal femur. N Engl J Med 2010; 362:1761-71.
  • Fowler JR, Craig MR. Association of low-energy femoral shaft fractures and bisphosphonate use. Orthopedics 2012;35:e38-40.
  • Lenart BA, Neviaser AS, Lyman S, Chang CC, Edobor- Osula F, Steele B, et al. Association of low-energy femoral fractures with prolonged bisphosphonate use: a case control study. Osteoporos Int 2009;20:1353-62.
  • Park-Wyllie LY, Mamdani MM, Juurlink DN, Hawker GA, Gunraj N, Austin PC, et al. Bisphosphonate use and the risk of subtrochanteric or femoral shaft fractures in older women. JAMA 2011;305:783-9.

Diaphyseal femur fractures associated with bisphosphonate use

Yıl 2013, Cilt: 47 Sayı: 4, 255 - 260, 18.09.2013

Öz

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.

Kaynakça

  • Lenart BA, Lorich DG, Lane JM. Atypical fractures of the femoral diaphysis in postmenopausal women taking alen- dronate. N Engl J Med 2008;358:1304-6.
  • Neviaser AS, Lane JM, Lenart BA, Edobor-Osula F, Lorich DG. Low-energy femoral shaft fractures associated with alendronate use. J Orthop Trauma 2008;22:346-50.
  • Visekruna M, Wilson D, McKiernan FE. Severely sup- pressed bone turnover and atypical skeletal fragility. J Clin Endocrinol Metab 2008;93:2948-52.
  • Odvina CV, Zerwekh JE, Rao DS, Maalouf N, Gottschalk FA, Pak CY. Severely suppressed bone turnover: a potential com- plication of alendronate therapy. J Clin Endocrinol Metab 2005;90:1294-301.
  • Goh SK, Yang KY, Koh JS, Wong MK, Chua SY, Chua DT, et al. Subtrochanteric insufficiency fractures in patients on alendronate therapy: a caution. J Bone Joint Surg Br 2007; 89:349-53.
  • Armamento-Villareal R, Napoli N, Diemer K, Watkins M, Civitelli R, Teitelbaum S, et al. Bone turnover in bone biop- sies of patients with low-energy cortical fractures receiving bisphosphonates: a case series. Calcif Tissue Int 2009;85:37- 44.
  • Cheung RK, Leung KK, Lee KC, Chow TC. Sequential non-traumatic femoral shaft fractures in a patient on long- term alendronate. Hong Kong Med J 2007;13:485-9.
  • Armamento-Villareal R, Napoli N, Panwar V, Novack D. Suppressed bone turnover during alendronate therapy for high-turnover osteoporosis. N Engl J Med 2006;355:2048- 50.
  • Capeci CM, Tejwani NC. Bilateral low-energy simultaneous or sequential femoral fractures in patients on long-term alendronate therapy. J Bone Joint Surg Am 2009;91:2556- 61.
  • Kwek EB, Goh SK, Koh JS, Png MA, Howe TS. An emerg- ing pattern of subtrochanteric stress fractures: a long-term complication of alendronate therapy? Injury 2008;39:224- 31.
  • Ing-Lorenzini K, Desmeules J, Plachta O, Suva D, Dayer P, Peter R. Low-energy femoral fractures associated with the long-term use of bisphosphonates: a case series from a Swiss university hospital. Drug Saf 2009;32:775-85.
  • Isaacs JD, Shidiak L, Harris IA, Szomor ZL. Femoral insuf- ficiency fractures associated with prolonged bisphosphonate therapy. Clin Orthop Relat Res 2010;468:3384-92.
  • Shane E, Burr D, Ebeling PR, Abrahamsen B, Adler RA, Brown TD, et al; American Society for Bone and Mineral Research. Atypical subtrochanteric and diaphyseal femoral fractures: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res 2010;25: 2267-94.
  • Possible increased risk of thigh bone fracture with bisphos- phonates [Internet]. Food and Drug Administration (FDA) [cited 2010 Jan 26]. Available from: http://www.fda.gov/ NewsEvents/Newsroom/PressAnnouncements/ucm229171. htm.
  • Abrahamsen B, Eiken P, Eastell R. Subtrochanteric and dia- physeal femur fractures in patients treated with alendronate: a register-based national cohort study. J Bone Miner Res 2009;24:1095-102.
  • Black DM, Kelly MP, Genant HK, Palermo L, Eastell R, Bucci-Rechtweg C, et al; Fracture Intervention Trial Steering Committee; HORIZON Pivotal Fracture Trial Steering Committee. Bisphosphonates and fractures of the subtrochanteric or diaphyseal femur. N Engl J Med 2010; 362:1761-71.
  • Fowler JR, Craig MR. Association of low-energy femoral shaft fractures and bisphosphonate use. Orthopedics 2012;35:e38-40.
  • Lenart BA, Neviaser AS, Lyman S, Chang CC, Edobor- Osula F, Steele B, et al. Association of low-energy femoral fractures with prolonged bisphosphonate use: a case control study. Osteoporos Int 2009;20:1353-62.
  • Park-Wyllie LY, Mamdani MM, Juurlink DN, Hawker GA, Gunraj N, Austin PC, et al. Bisphosphonate use and the risk of subtrochanteric or femoral shaft fractures in older women. JAMA 2011;305:783-9.
Toplam 19 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Orijinal Makale
Yazarlar

Jove Graham Bu kişi benim

Kaan Irgit Bu kişi benim

Wade R. Smith Bu kişi benim

Thomas R. Bowen Bu kişi benim

Yayımlanma Tarihi 18 Eylül 2013
Yayımlandığı Sayı Yıl 2013 Cilt: 47 Sayı: 4

Kaynak Göster

APA Graham, J., Irgit, K., Smith, W. R., Bowen, T. R. (2013). Diaphyseal femur fractures associated with bisphosphonate use. Acta Orthopaedica Et Traumatologica Turcica, 47(4), 255-260.
AMA Graham J, Irgit K, Smith WR, Bowen TR. Diaphyseal femur fractures associated with bisphosphonate use. Acta Orthopaedica et Traumatologica Turcica. Eylül 2013;47(4):255-260.
Chicago Graham, Jove, Kaan Irgit, Wade R. Smith, ve Thomas R. Bowen. “Diaphyseal Femur Fractures Associated With Bisphosphonate Use”. Acta Orthopaedica Et Traumatologica Turcica 47, sy. 4 (Eylül 2013): 255-60.
EndNote Graham J, Irgit K, Smith WR, Bowen TR (01 Eylül 2013) Diaphyseal femur fractures associated with bisphosphonate use. Acta Orthopaedica et Traumatologica Turcica 47 4 255–260.
IEEE J. Graham, K. Irgit, W. R. Smith, ve T. R. Bowen, “Diaphyseal femur fractures associated with bisphosphonate use”, Acta Orthopaedica et Traumatologica Turcica, c. 47, sy. 4, ss. 255–260, 2013.
ISNAD Graham, Jove vd. “Diaphyseal Femur Fractures Associated With Bisphosphonate Use”. Acta Orthopaedica et Traumatologica Turcica 47/4 (Eylül 2013), 255-260.
JAMA Graham J, Irgit K, Smith WR, Bowen TR. Diaphyseal femur fractures associated with bisphosphonate use. Acta Orthopaedica et Traumatologica Turcica. 2013;47:255–260.
MLA Graham, Jove vd. “Diaphyseal Femur Fractures Associated With Bisphosphonate Use”. Acta Orthopaedica Et Traumatologica Turcica, c. 47, sy. 4, 2013, ss. 255-60.
Vancouver Graham J, Irgit K, Smith WR, Bowen TR. Diaphyseal femur fractures associated with bisphosphonate use. Acta Orthopaedica et Traumatologica Turcica. 2013;47(4):255-60.