No abstract available.
Apoptosis* ; Diphosphonates*

Atypical femoral fractures (AFFs) are rare adverse effects of bisphosphonate therapy. We report an unusual case of bilateral diaphyseal AFFs in an antiresorptive-naïve Singaporean Chinese female with Graves’ disease. She presented with complete right AFF requiring surgical fixation, and persistent left incomplete AFF for over four years. Femoral bowing, varus femoral geometry, and ethnic influence likely contributed to the AFFs’ formation. This case may provide insights into the pathogenesis of AFFs in high-risk Asian populations.
Diphosphonates ; Hyperthyroidism

No abstract available.
Alendronate* ; Animals ; Diphosphonates ; Rats*

No abstract available.
Diphosphonates* ; Osteoclasts* ; Tyrosine*

Much attention has been paid to the relationship between atypical femoral fractures (AFF) and use of bisphosphonates (BPs). While a significant cause-effect relationship was not established in earlier studies, more recent data shows a growing relationship between AFF and BPs use. The definition of an 'AFF' has also undergone significant changes. This review briefly summarizes the definition, pathogenesis, and management of AFF.
Bone Remodeling ; Diphosphonates ; Femoral Fractures*

OBJECTIVES: To analyze the adherence of once-yearly intravenous zolendronic acid for osteoporosis. MATERIALS AND METHODS: The subjects were 322 osteoporotic patients who received more than single infusion of zolendronic acid. On clinical assessment, we assessed adherence. The changes of bone mineral density (BMD) and bone turnover marker were measured before and after infusion. RESULTS: Reinfusion rate was 48.4% (109/225) at second infusion, and 51.3% (41/80) at third infusion. Adverse event at each time was 161 (42.1%) cases, 30 (27.5%) cases, and 8 (19.5%) cases, respectively. The measured mean BMD change was significantly increased (P-value<0.001). CONCLUSIONS: In this study, once-yearly intravenous zolendronic acid for 2 years was safe and efficacious in terms of BMD and bone turnover marker. The adherence was higher than most published studies of adherence to oral bisphosphonates, but lower than optimal. Physicians should fully explain to patients about medications and educate to improve their adherence.
Bone Density ; Diphosphonates ; Humans ; Osteoporosis

Postmenopause ; Osteoporosis ; Bone Density ; Diphosphonates

Diphosphonates ; adverse effects ; Humans ; Osteonecrosis ; chemically induced

BACKGROUND: Bisphosphonate (BP) has the ability to thicken the cortical bone. In addition, it has been reported that the cortical bone thickened by BP has relation to the medication-related osteonecrosis of the jaw (MRONJ). Therefore, the objective of this article is to analyze the ratio as well as thickness of cortical bone in the mandible using computed tomography (CT) and to evaluate it as the predictive factor of MRONJ. METHODS: The thickness of the cortical bone was measured on a paraxial view of the CT showing the mental foramen in 95 patients: 33 patients with MRONJ (3 males, 30 females), 30 patients taking BP without MRONJ (2 males, 28 females), and 32 controls (9 males, 28 females). Also, the ratios of the cortical bone to the total bone were obtained using the measured values. Based on these results, we compared the difference of mandibular cortical bone ratio between the three groups. RESULTS: The average cortical bone thickness was measured as 3.81 mm in patients with MRONJ, 3.39 mm in patients taking BP without MRONJ, and 3.23 mm in controls. There was only a significant difference between patients with MRONJ and controls (P < 0.05). On the other hand, the average mandibular cortical bone ratio was measured as 37.9% in patients with MRONJ, 27.9% in patients taking BP without MRONJ, and 23.3% in controls. There was a significant difference between all groups (P < 0.05). CONCLUSION: The mandibular cortical bone ratio is large in order of patients with MRONJ, patients taking BP without MRONJ, and controls. This result suggests that the mandibular cortical bone ratio would be very useful to predict the development of MRONJ.
Diphosphonates ; Hand ; Humans ; Jaw ; Male ; Mandible ; Osteonecrosis

Bisphosphonates have been used as first-line therapy to reduce the incidence of osteoporotic fractures. Several publications have recently described the occurrence of low-energy subtrochanteric and femoral shaft fractures with long-term bisphosphonate use, so called atypical femoral fracture. Atypical fracture is a rare condition, and the treatment and its effectiveness have not been adequately reported. Thus, finding appropriate treatment is difficult. In this report, the authors reviewed the treatment of atypical fracture and described helpful suggestions for surgery.
Diphosphonates ; Femoral Fractures ; Incidence ; Osteoporotic Fractures