Comparison of Radiographic Fracture Healing in the Distal Radius for Patients on and off Bisphosphonate Therapy

Rozental, Tamara D.; Vazquez, Michael A.; Chacko, Aron T.; Ayogu, Nworah; Bouxsein, Mary L.

doi:10.1016/j.jhsa.2008.12.011

Cited by 91 publications

(71 citation statements)

References 36 publications

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“…Hike in the BMD of the hip and lumbar spine, as well as decrease in nonspine fracture incidence in postmenopausal women with osteoporosis, was seen to occur as a result of alendronate. A study conducted by Rozental et al [15], in 2009, looked into a comparison of healing rates of distal radius fractures in patients who were on bisphosphonate therapy at the injury time with those who were not on it. A total of 196 patients were considered out of which the patients who were on the therapy were 43 and those who were not, made up the control group with 153 patients.…”

Section: Discussionmentioning

confidence: 99%

“…While the risk of using bisphosphonates has been found to be statistically significant in many of these studies, it is a worthy point that the clinical significance is still unclear. Bisphosphonates are seen to be highly beneficial in decreasing fracture risk and it is a fact that the anguish and fatality associated with a new fracture occurrence is higher than that of nonunions which have been seen [15]. Hence, a proper evaluation of when to start the treatment following a fracture requires in-depth analysis as a delayed start must not result in initiation issues with these agents.…”

Section: Discussionmentioning

confidence: 99%

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Effect of Alendronate on the Healing Time of Distal Radial Fractures Treated Conservatively: An Observational Study

Koshy

Pinto

Sujir

et al. 2017

Asian J Pharm Clin Res

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Objective: Although fragility fractures of the distal radius are common, osteoporosis treatment requires exploration as attempts to improve postfracture investigations have been only partially successful. Bisphosphonates may help minimize the risk of secondary fractures but being a potent antiresorptive agent; it raises concerns about adverse effects on the healing process. This observational study examines the effect of bisphosphonate (alendronate) on healing of acute fractures of distal radius through 66 patients aged >45 years admitted to two tertiary care hospitals in Mangalore from May 2014 to September 2016. Methods:The methodology consists of purposive sampling from two groups: Control having 33 patients not on alendronate therapy and cases comprising 33 who are on alendronate as part of prophylaxis for osteoporosis before fracture occurrence, with outpatient reviews at 2-week intervals starting from the 6 th till fracture union seen. At each visit, plain radiographs of the involved wrist were taken to yield time to cortical bridging, with range of active movement of the affected wrist taken using a goniometer. Data were analyzed using Statistical Package for the Social Sciences software version 17.0 for t values, p values and correlations and results were presented in the form of graphs and tables.Results: No significant differences were observed in the groups (as per p values) w.r.t. gender (0.804), age (0.835), time to healing (1.000), dorsiflexion (0.956), palmar flexion (0.670), ulnar deviation (0.441), radial deviation (1.000), supination (0.132), or pronation (0.302). Quick Disabilities of the Arm, Shoulder and Hand score did not differ by >95% between the groups over the analysis period. Conclusion:It was observed that alendronate administration in distal radius fractures did not appear to delay fracture healing times radiologically or clinically.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effect of Alendronate on the Healing Time of Distal Radial Fractures Treated Conservatively: An Observational Study

Koshy

Pinto

Sujir

et al. 2017

Asian J Pharm Clin Res

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“…Previous studies on the effect of bisphosphonate on fracture healing in humans have reported inconsistent results, [17][18][19][20][21][22][23] which may arise from differences in study design, primary outcome measures, the bisphosphonate used and fracture site studied. Most of the studies found no adverse effect of bisphosphonate on fracture healing.…”

Section: Discussionmentioning

confidence: 99%

“…[14][15][16] Human studies on the effect of bisphosphonate administration on the healing of acute fractures have yielded inconsistent results. [17][18][19][20][21][22][23] We have undertaken a multicentre, prospective clinical trial to test whether early administration of the bisphosphonate alendronate (ALN) delayed radiological and clinical healing after surgery for distal radial fragility fractures regardless of the bone mineral density (BMD) measured at the lumbar spine. Our hypothesis was that early ALN administration would have no apparent adverse effects on radiologically assessed fracture union.…”

mentioning

confidence: 99%

Effect of early administration of alendronate after surgery for distal radial fragility fracture on radiological fracture healing time

Uchiyama

Itsubo

Nakamura

et al. 2013

The Bone & Joint Journal

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“…Although treatment with teriparatide is associated with an increase in bone formation markers within 3 months and bone resorption markers within 6 months [30,41], conditions such as longterm bisphosphonate therapy could adversely affect the anabolic responses to this agent. Prolonged bisphosphonate treatment temporarily suppresses bone markers [50] and thus reduces the skeletal responses to teriparatide [9,15,17,24,37,43].…”

Section: Introductionmentioning

confidence: 99%

A Fracture Does Not Adversely Affect Bone Mineral Density Responses after Teriparatide Treatment

Unnanuntana

Ton

Kleimeyer

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Fracture leads to local and systemic catabolic physiologic changes. As teriparatide is an agent used to treat osteoporosis in patients with fragility fractures, it is unclear whether teriparatide treatment alters bone mineral density (BMD) and bone markers when given to patients with fractures. Questions/purposes We asked whether BMD and bone marker responses would be blunted in patients with fractures placed on teriparatide after fracture compared with patients without fractures on teriparatide. Patients and MethodsWe retrospectively collected data from 141 patients treated with teriparatide for osteoporosis. Seventy-seven patients received teriparatide after fractures (fracture group), whereas 64 were treated for other indications (nonfracture group). We determined BMD at the lumbar spine and at the proximal femur before and 12 and 24 months posttreatment. Bone markers (urine N-telopeptide [urine NTX], bone-specific alkaline phosphatase [BALP]) were measured at baseline and 3, 12, and 24 months posttreatment. Results Mean lumbar spine and hip BMDs at last followup increased from baseline with no differences between groups to approximately 9% and 4% at 24 months, respectively. Both bone markers increased from baseline in the nonfracture group, peaking at 12 months. For the fracture group, only urine NTX increased at 3 and 12 months posttreatment. Although the peak levels of both bone markers in the nonfracture group were greater, there was no difference between the two groups. Conclusions Fracture does not have a negative effect on the BMD and bone marker responses to teriparatide treatment. Clinicians should anticipate comparable BMD responses when treating patients with teriparatide for osteoporotic fractures and for other indications. Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Comparison of Radiographic Fracture Healing in the Distal Radius for Patients on and off Bisphosphonate Therapy

Cited by 91 publications

References 36 publications

Effect of Alendronate on the Healing Time of Distal Radial Fractures Treated Conservatively: An Observational Study

Effect of Alendronate on the Healing Time of Distal Radial Fractures Treated Conservatively: An Observational Study

Effect of early administration of alendronate after surgery for distal radial fragility fracture on radiological fracture healing time

A Fracture Does Not Adversely Affect Bone Mineral Density Responses after Teriparatide Treatment

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