PT  - JOURNAL ARTICLE
AU  - Alwahhabi, Basmah K.
AU  - Alsuwaine, Basil A.
TI  - Long-term use of bisphosphonates in osteoporosis
AID  - 10.15537/smj.2017.6.19793
DP  - 2017 Jun 01
TA  - Saudi Medical Journal
PG  - 604--608
VI  - 38
IP  - 6
4099  - http://smj.org.sa/content/38/6/604.short
4100  - http://smj.org.sa/content/38/6/604.full
SO  - Saudi Med J2017 Jun 01; 38
AB  - Objectives: To report and describe the management and response to treatment of patients referred to the osteoporosis clinic after prolonged use of bisphosphonate BPs) (4 years and more) with and without new fracture (any site) or any other new skeletal symptoms.Methods: This is a single center observational retrospective cohort study conducted from January 2009 to May 2016 in a tertiary center. We describe cause of referral, X-rays findings, management, and response to treatment.Results: Thirty-four patients, aged 46-89 years, were collected. Reason for referral included review of therapy (11 patients), recent low trauma fracture (21 patients), or chronic severe thigh pain (2 patients) of unknown etiology. All patients with fracture or thigh pain (23/34 patients) were treated with teriparatide 20 mcg daily. Sixteen of them (16/23) completed teriparatide course (18-24 months), 11 patients had complete healing of fracture at the end of the course, and 5 remained with nonunion of fracture, the remaining 5 patients were lost to follow up.Conclusion: Prolonged use of bisphosphonates can lead to atypical femoral fracture that may involve sites other than femoral shaft or rarely chronic thigh pain without fracture. Teriparatide may facilitates fracture healing and improve thigh pain.