To the Editor: The study by Dr Park-Wyllie and colleagues1 provided evidence that prolonged bisphosphonate treatment results in a small increased risk of fracture in the subtrochanteric and proximal femoral areas. The cases were considerably different from controls at baseline, with higher rates of previous falls, previous fractures, dementia, congestive heart failure, proton pump inhibitor use, antidepressant use, and opioid prescriptions. We wonder if these variables were also significantly higher in women who had fractures with 5 or more years of treatment when compared with those with transient, short-term, or intermediate treatment duration. This might help identify those who are more vulnerable to such fractures.
Pfister AK, Trotter CC. Bisphosphonate Use and Femoral Fractures in Older Women. JAMA. 2011;305(20):2068-2069. doi:10.1001/jama.2011.674