Is Bisphosphonate Therapy Safe Shortly After an Osteoporotic Fracture?

Bisphosphonates interfere with osteoclast activity and can affect bone remodeling. Thus, some clinicians have expressed concern that administering these drugs too soon after an osteoporosis-related fracture could interfere with fracture healing and lead to fracture nonunion. However, studies on this point have yielded mixed results.

In this latest study, researchers used U.S. Medicare claims data from 2016 to 2019 to identify 111,000 patients (age, ≥65) with operatively treated long-bone fractures; most were lower-extremity fractures, but 11% were in an upper extremity. The incidence of fracture nonunion at 1 year was 9%. On multivariable analysis, receiving a bisphosphonate prescription within 90 days after fracture was not associated with …