RT Journal Article
T1 Oral bisphosphonates are associated with increased risk of subtrochanteric and diaphyseal fractures in elderly women: a nested case–control study
A1 Ervity, Juan
A1 Alonso, Álvaro
A1 Oliva, Belén
A1 Gorricho, Javier
A1 López, Antonio
A1 Timoner, Julia
A1 Huerta Álvarez, María Consuelo Yolanda
A1 Gil, Miguel
A1 Abajo, Francisco de
AB Objectives To evaluate the association between bisphosphonate use and the risk of atypical femoral fractures among women aged 65 or older.Design Nested case–control study.Setting General practice research database in Spain.Exposures Use of oral bisphosphonates before the occurrence of atypical fractures among cases or the corresponding index date among controls. Bisphosphonate use was categorised as ever versus never users. Ever users were divided according to the total time since first prescription.Main outcome measures Cases were defined as women aged 65 years or older with a first diagnosis of subtrochanteric or diaphyseal fracture, recorded in the BIFAP database between 1 January 2005 and 31 December 2008, and with at least 1 year of follow-up before the index date. For each case, five age-matched and calendar-year-matched controls without a history of hip or atypical fracture were randomly selected from the database.Statistical analysis OR of atypical femoral fracture by bisphosphonate use was determined using conditional logistic regression. Models were adjusted for comorbidities and use of other medications.Results The analysis included 44 cases and 220 matched controls (mean age, 82 years). Ever use of bisphosphonates was more frequent in cases than controls (29.6% vs 10.5%). In multivariate analyses, OR (95% CI) of atypical femoral fracture was 4.30 (1.55 to 11.9) in ever versus never users of bisphosphonates. The risk increased with long-term use, with an OR of 9.46 (2.17 to 41.3) comparing those using bisphosphonates over 3 years versus no users (p for trend=0.01).Conclusions Bisphosphonate use was associated with an increased risk of subtrochanteric or diaphyseal fractures in elderly women in a low fracture risk population, with a higher risk among long-term bisphosphonate users.
PB BMJ Publishing Group Ltd
SN 2044-6055
YR 2012
FD 2012-12-21
LK https://hdl.handle.net/20.500.14352/132068
UL https://hdl.handle.net/20.500.14352/132068
LA eng
NO Erviti J, Alonso A, Oliva B, Gorricho J, López A, Timoner J, Huerta C, Gil M, De Abajo F. Oral bisphosphonates are associated with increased risk of subtrochanteric and diaphyseal fractures in elderly women: a nested case-control study. BMJ Open. 2013 Jan 30;3(1):e002091. doi: 10.1136/bmjopen-2012-002091
NO Ministerio de Sanidad (España)
DS Docta Complutense
RD 21 mar 2026