HealthDay News — For patients with osteopenia or osteoporosis, taking a bisphosphonate (BP) drug holiday is associated with increased risk of fracture for patients with lower femoral neck bone mineral density (BMD) or T scores, according to a recent study published in Endocrine Practice.

Brittany Bindon, MD, from the University of Chicago, and colleagues conducted a retrospective chart review of 401 patients with osteopenia or osteoporosis who began a BP drug holiday from 2004 to 2013. 

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The researchers found that 15.4% of the patients developed a fracture during follow-up. Yearly fracture incidence varied from 3.7 to 9.9%, peaking during years four and five at 9.9 and 9.8%, respectively. The fracture group had a higher age than the non-fracture group, although the difference was not significant (69.24 ± 12.26 years vs 66.42 ± 10.18 years; P=.09). At baseline, the fracture group had lower femoral neck BMD (0.75 ± 0.12 g/cm² vs 0.79 ± 0.10 g/cm²; P=.03) and T scores (−2.13 ± 0.99 vs −1.78 ± 0.79; P=0.01) than the non-fracture group.

“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 authors write. “Fracture risk analysis needs to be regularly assessed during the drug holiday and treatment resumed accordingly.”

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One author disclosed financial ties to Amgen.

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