Skip to main content
Top
Published in: Osteoporosis International 2/2016

01-02-2016 | Case Report

Simultaneous bilateral atypical femoral fracture in a patient receiving denosumab: case report and literature review

Authors: J. Selga, J. H. Nuñez, J. Minguell, M. Lalanza, M. Garrido

Published in: Osteoporosis International | Issue 2/2016

Login to get access

Abstract

Osteoporosis remains a chronic and common disease associated with high medical costs. Pharmacological therapy has shown to be a good strategy to significantly reduce fracture risk. While literary evidence for bone protection in the short and medium term is strongly in it’s favor, there are concerns about long-term treatment with antiresorptive drugs. Increased risk of atypical femoral fractures (AFFs) have been demonstrated in several studies following the long-term use of bisphosphonate. Denosumab offers an alternative approach to the treatment of osteoporosis, however, it is also an antiresorptive drug. We present a case of simultaneous bilateral atypical femoral fractures in a patient with denosumab treatment. These findings highlight the need to reevaluate the optimal antiresorptive therapy duration, as well as the safety of transition from bisphosphonates to denosumab and the need for continued monitoring in the prevention of AFFs.
Literature
4.
go back to reference Unnanuntana A, Saleh A, Mensah KA, Kleimeyer JP, Lane JM (2013) Atypical femoral fractures: what do we know about them?: AAOS Exhibit Selection. J Bone Joint Surg Am 95(2):e8 1–13. doi:10.2106/JBJS.L.00568 CrossRef Unnanuntana A, Saleh A, Mensah KA, Kleimeyer JP, Lane JM (2013) Atypical femoral fractures: what do we know about them?: AAOS Exhibit Selection. J Bone Joint Surg Am 95(2):e8 1–13. doi:10.​2106/​JBJS.​L.​00568 CrossRef
5.
go back to reference Cummings SR, San Martin J, McClung MR, Siris ES, Eastell R, Reid IR, Delmas P, Zoog HB, Austin M, Wang A, Kutilek S, Adami S, Zancetta J, Libanati C, Siddhanti S, Christiansen C (2009) Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med 361(8):756–65. doi:10.1056/NEJMoa0809493 CrossRefPubMed Cummings SR, San Martin J, McClung MR, Siris ES, Eastell R, Reid IR, Delmas P, Zoog HB, Austin M, Wang A, Kutilek S, Adami S, Zancetta J, Libanati C, Siddhanti S, Christiansen C (2009) Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med 361(8):756–65. doi:10.​1056/​NEJMoa0809493 CrossRefPubMed
14.
go back to reference S. Papapoulos, K. Lippuner, et al. The effect of 8 or 5 years of denosumab treatment in postmenopausal women with osteoporosis: results from the FREEDOM Extension study. Osteoporos Int. 2015 Jul 23. [Epub ahead of print]. doi: 10.1007/s00198-015-3234-7. S. Papapoulos, K. Lippuner, et al. The effect of 8 or 5 years of denosumab treatment in postmenopausal women with osteoporosis: results from the FREEDOM Extension study. Osteoporos Int. 2015 Jul 23. [Epub ahead of print]. doi: 10.​1007/​s00198-015-3234-7.
17.
21.
go back to reference Shane E, Burr D, Abrahamsen B, Adler RA, Brown TD et al (2014) Atypical subtrochanteric and diaphyseal femoral fractures: second report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res 29(1):1–23. doi:10.1002/jbmr.1998 CrossRefPubMed Shane E, Burr D, Abrahamsen B, Adler RA, Brown TD et al (2014) Atypical subtrochanteric and diaphyseal femoral fractures: second report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res 29(1):1–23. doi:10.​1002/​jbmr.​1998 CrossRefPubMed
23.
go back to reference Craig M, Capeci MD, Nirmal C, Tejwani MD (2009) Bilateral low-energy simultaneous or sequential femoral fractures in patients on long-term alendronate therapy. J Bone Joint Surg Am 91(11):2556–61. doi:10.2106/JBJS.H.01774 CrossRef Craig M, Capeci MD, Nirmal C, Tejwani MD (2009) Bilateral low-energy simultaneous or sequential femoral fractures in patients on long-term alendronate therapy. J Bone Joint Surg Am 91(11):2556–61. doi:10.​2106/​JBJS.​H.​01774 CrossRef
27.
go back to reference Zafeiris CP, Stathopoulos IP, Kourkoumelis G, Gkikas E, Lyritis GP (2012) Simultaneous bilateral atypical femoral fractures after alendronate therapy. J Musculoskelet Neuronal Interact 12(4):262–4PubMed Zafeiris CP, Stathopoulos IP, Kourkoumelis G, Gkikas E, Lyritis GP (2012) Simultaneous bilateral atypical femoral fractures after alendronate therapy. J Musculoskelet Neuronal Interact 12(4):262–4PubMed
Metadata
Title
Simultaneous bilateral atypical femoral fracture in a patient receiving denosumab: case report and literature review
Authors
J. Selga
J. H. Nuñez
J. Minguell
M. Lalanza
M. Garrido
Publication date
01-02-2016
Publisher
Springer London
Published in
Osteoporosis International / Issue 2/2016
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-015-3355-z

Other articles of this Issue 2/2016

Osteoporosis International 2/2016 Go to the issue