Selga J, Nuñez J H, Minguell J, Lalanza M, Garrido M
Osteoporos Int. 2016 Feb;27(2):827-32. doi: 10.1007/s00198-015-3355-z.
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.
骨质疏松症仍然是一种慢性常见疾病，伴随着高昂的医疗费用。药物治疗已被证明是显著降低骨折风险的良好策略。虽然有充分的文献证据表明其在短期和中期对骨骼有保护作用，但人们对使用抗吸收药物进行长期治疗存在担忧。多项研究表明，长期使用双膦酸盐后非典型股骨骨折（AFFs）的风险增加。地诺单抗为骨质疏松症的治疗提供了另一种方法，然而，它也是一种抗吸收药物。我们报告一例接受地诺单抗治疗的患者同时发生双侧非典型股骨骨折的病例。这些发现凸显了重新评估抗吸收治疗的最佳持续时间的必要性，以及从双膦酸盐转换为地诺单抗的安全性和在预防非典型股骨骨折方面持续监测的必要性。
