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In this blog post, we discuss a common scenario in the clinic that highlights the importance of regular medication review and dialogue between patients and healthcare teams.

Our patient focus has been on bisphosphonate therapy for a staggering ten years. While bisphosphonates have a role in osteoporosis, they are not generally recommended for such extended periods due to potential complications.

Bisphosphonates work by slowing down the cells that break down bone (osteoclasts), reducing the rate at which bone is lost. While this is a positive for individuals who have osteoporosis, long-term use of bisphosphonates (typically beyond five years) can sometimes lead to an increase in certain fracture risks.

london ost

Atypical Hip Fracture, Shin et al. ScienceDirect 2016

One particularly concerning complication is atypical femoral fractures (AFFs), fractures that can occur in the bone just below the hip joint or the long part of the thigh bone, with little or no trauma. An increasing body of evidence suggests these fractures can occur more frequently after long-term use of bisphosphonates, though they are still considered quite rare.

However, it’s important to note that deciding to continue or stop bisphosphonates after five years is complex and should be individualised. Factors such as your initial fracture risk, age, and overall health should be considered.

If you or a loved one have been on bisphosphonates for an extended period, discussing this with your clinical team is essential. Regular treatment reviews can help ensure you receive the most optimal, personalised, and up-to-date care possible.

Remember, optimal osteoporosis treatment often involves more than just medication. A balanced diet rich in calcium and vitamin D, regular weight-bearing and muscle-strengthening exercises, cessation of smoking, and reduced alcohol intake all play significant roles in maintaining bone health.

As always, we’re here to provide expert care and guidance on osteoporosis-related things. Please don’t hesitate to reach out with any concerns or questions. We’re all on this journey together.