A John’s Hopkins Health Alert titled “How Long Is It Safe to Take Bisphosphonates for Osteoporosis?” Should Raise Some Concerns Men on Long Term Bisphosphonate Therapy
Hormone therapy (ADT) is notorious for many negative side effects, including osteoporosis. Osteoporosis is the thinning of bone that increases the risk for fractures, especially hip and spine fractures. For some men these fractures could be fatal.
Bisphosphonates, when used consistently for three to five years are effective in preventing and treat osteoporosis. Many men on ADT who are hormone refractory are also on a bisphosphonate, most commonly Zoledronic acid (Zometa) or Denosumab (Xgeva).
According to a Johns Hopkins alert there isa growing body of evidence that has linked the extended use of bisphosphonate therapy to an increasing risk of developing an uncommon and very serious fracture in the thigh bone (femur).
This means that you need to discuss this increased risk with your doctor if you are on bisphosphonate therapy. The question you need to ask is, how long should I take bisphosphonates?
The mixed results of long-term bisphosphonate use were shown in a 2011 study published in the Journal of the American Medical Association (JAMA). “Researchers found that older women who had used bisphosphonates for at least five years had a 24 percent lower risk of developing fractures in the hip and spine than their counterparts on bisphosphonate therapy for less than five years. But the long-time users were more likely to develop fractures in the thigh bone just below the hip joint (subtrochanteric) and further down in the long straight part of the thigh bone (femoral shaft) — areas where fractures are not typically seen in people with osteoporosis.”
What makes this finding more important to consider is that the atypical femoral fractures often occurred after a minor trauma. Small, normally minor incidents like tripping, stepping off an elevator or being jolted by a sudden subway stop can cause these fractures.
Link: Johns Hopkins Health Alert on Bisphosphonate Use
Joel T. Nowak, M.A., M.S.W.