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By Alvin B. Lin
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Bisphosphonates & Atypical Femur Fractures: Part 3 - Take Teriparatide!

Posted Apr 07 2011 8:21am
We've taken a hard look at bisphosphonates lately, first in December and then in February .  The consensus now is to take them only if necessary (and only after clearance from your dentist) and then only for about 5 years with the understanding that bisphosphonates do lower the risk of osteoporotic fractures which overrides the extremely low risk of an atypical fracture (although admittedly it is increased).  

But what if you're too late to heed this new bit of advice?  Let's say you've been taking your bisphosphonate for over a decade, even 13 years.  And to make matters worse, what if you were just diagnosed w/bilateral femoral stress fractures?
In a case report to be published in the June issue of the Journal of Clinical Endocrinology & Metabolism , the authors reported healing after bringing this 63 year old female patient's vitamin D level back into the normal range and then offering her teriparatide, the daily injectable recombinant parathyroid hormone, for 16 months.

Now, don't get me wrong.  I'm not recommending that you start teriparatide based upon one patient's experience.  But if you (or your patient) find yourself in a similar situation, consider looking at the study in detail.


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