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Previous Volume 358:1304-1306 March 20, 2008 Number 12 Next

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To the Editor: The long-term safety of bisphosphonates for the treatment of osteoporosis has been questioned. Two case series have suggested a link between prolonged bisphosphonate therapy and atypical fractures. In one series, a small number of patients sustained low-energy nonvertebral fractures while receiving long-term alendronate therapy; three were fractures of the femoral shaft.¹ Bone biopsies in these patients showed evidence of severely suppressed bone turnover and fracture healing that was delayed or absent. In the other series, low-energy subtrochanteric fractures were found in nine women who had been receiving long-term alendronate therapy.² Theoretically, bisphosphonates suppress bone turnover and thus . . . [Full Text of this Article]

Related Letters:

More on Atypical Fractures of the Femoral Diaphysis
Kwek E. B.K., Koh J. S.B., Howe T. S., Lee P., Seibel M. J., Lenart B. A., Lorich D. G., Lane J. M.
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N Engl J Med 2008; 359:316-318, Jul 17, 2008. Correspondence

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