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Bisphosphonates lower risk for vertebral and hip fracture in women with postmenopausal osteoporosis, yet concern about risk for atypical femur fractures has triggered avoidance of such therapy by both patients and clinicians. Reliable data about the benefits and risks of bisphosphonate therapy beyond 3 to 5 years are scant. In this cohort study containing two nested case-control studies, investigators used the Danish prescription registry to determine risks for hip fracture and subtrochanteric/femoral shaft fractures in women who received alendronate for ≥10 years.
Among some 62,000 alendronate users (median follow-up, 6.9 years; 29.4% completed 5 years of therapy), 6784 hip fractures and 1428 subtrochanteric/femoral shaft fractures occurred…