Fracture Risk Reduction With Alendronate in Women With Osteoporosis: The Fracture Intervention Trial

Femoral Insufficiency Fractures Associated with Prolonged Bisphosphonate Therapy

“…Bisphosphonates are cost-effective treatment for management of osteoporosis and they reduce morbidity, disability, and mortality associated with fractures [1][2][3][4][5][6][7][8][9][10][11][12][13]. However, our observations suggest care must be taken when prescribing bisphosphonates for prolonged periods and doctors should be alerted by symptoms of thigh pain in patients taking them, because this may be a symptom of insufficiency changes in the femoral shaft.…”

Case‐Only Analysis of Treatment–Covariate Interactions in Clinical Trials

“…The Fracture Intervention Trial (FIT) was another large (N = 3475) clinical trial that evaluated the effect of alendronate on clinical as well as vertebral fracture among osteoporotic women (Black et al, 2000). Serum markers of bone turnover, including bone-specific alkaline phosphatase (BAP1) and N-terminal propeptide of type 1 collagen (P1NP), have been associated with lower bone mineral density and higher fracture risk in this population (Looker et al, 2000), and it has been hypothesized that alendronate might be more effective among subgroups with higher bone turnover.…”

Unusual mid‐shaft fractures during long‐term bisphosphonate therapy

“…Bisphosphonates are the most commonly used drugs in the prevention and treatment of osteoporosis. 1 Several placebo-controlled randomized trials have established their effectiveness in preventing bone loss and osteoporotic fractures, [2][3][4][5][6] and the recent extension trial with alendronate suggests that the medication is safe and effective for up to 10 years. 7 Another long-term study with risedronate demonstrated that 7 years of continuous therapy in postmenopausal women significantly increased bone mineral density (BMD), and decreased bone turnover marker to within premenopausal range with no indication of loss of antifracture efficacy.…”