Hip Fractures and Bisphosphonates

New study fails to find clear evidence bisphosphonates cause atypical femoral fractures.
ABC World News (3/24, story 8, 1:40, Sawyer) reported that a study published online March 25 in the New England Journal of Medicine "seems to give the reassurance that long-term use" of osteoporosis drugs "does not raise the risk of a thigh bone breaking."
The New York Times (3/25, A20, Kolata) reports that the study "fails to find clear evidence that bisphosphonates are causing" femoral fractures. In fact, the University of California-San Francisco researchers "report that the thighbone fractures are so rare, even in women taking bisphosphonates for up to 10 years, that it is not clear whether the drugs make them more likely. And, they report, if there is a risk, it is far outweighed by the drugs' clear benefit in preventing fractures of the hip and spine in people with osteoporosis."
To examine the risk of thighbone fractures, "researchers combined results from three large studies involving more than 14,000 women who were given Fosamax [alendronate], Reclast [zoledronic acid], or dummy treatments for three to 10 years," the AP (3/25, Marchione) reports. Altogether, "284 hip and leg fractures occurred, including 12 of the unusual upper-thigh type." While "there was a trend toward more of these unusual fractures among bisphosphonate users...the difference was small enough to have occurred by chance."
MedPage Today (3/24, Gever) reported that in an editorial accompanying the study, endocrinologist Elizabeth Shane, MD, of Columbia University, "urged physicians with concerns about atypical femoral fractures and bisphosphonates to avoid a 'rush to judgment.'" WebMD (3/24, DeNoon) and HealthDay (3/24, Gardner) also covered the story.