Osteoporosis patients who take drugs for long periods are typically advised to temporarily discontinue using them to prevent side effects. Findings of a new study, however, have found that those who take drug holidays are at an increased risk for fractures.
Bisphosphonates
Bisphosphonates are the most common drugs prescribed for people with osteoporosis. They work by slowing down the breakdown of bones, help maintain bone density, and reduce odds of fractures.
The medication has been associated with jaw (ONJ) and atypical femur fracture. ONJ may occur when the jawbone is exposed such as after a dental procedure, and starts to weaken and die. Atypical femur fracture is a fracture of the thigh bone.
To prevent or reduce the risk for these side effects, the American College of Endocrinology and the American Association of Clinical Endocrinologists recommend that women with moderate risk for osteoporosis go on a drug holiday after five years of taking the oral drug and three years of intravenous treatment. Those with higher risk for osteoporosis, on the other hand, are advised to take drug holiday after 10 years of oral and six years of intravenous treatment with bisphosphonate.
The new study revealed the fracture risk posed by drug holidays in osteoporosis patients.
Drug Holiday And Fracture Risk
Researchers of the new study published in the journal Endocrine Practice found that 15.4 percent of patients who take holidays from bisphosphonates experienced bone fractures. Sites commonly affected were the foot, wrist, ribs, and spines.
During a six-year follow-up period, study researcher Pauline Camacho, from Loyola University Medical Center, and colleagues found that the annual incidence of fractures range from 3.7 percent to 9.9 percent and that most fractures occurred during the fourth and fifth years.
The patients who were most likely to experience fracture are also those who were older and already had lower bone mineral density at the start of the study.
The researchers said that osteoporosis patients need to be monitored for fracture risk during a drug holiday.
"Patients who begin BP drug holidays at high risk of fracture based on BMD, age, or other clinical risk factors warrant close follow-up, especially as its duration lengthens," the researchers wrote in their study. "Fracture risk analysis needs to be regularly assessed during the drug holiday and treatment resumed accordingly."
Osteoporosis In Women
Osteoporosis is more common in women affecting one in four women who are 65 years old and older. The condition affects one in 20 men in the same age group.
