Will long-term treatment with bisphosphonates cause my bones to be brittle?
Bisphosphonates are effective in preventing fracture by slowing the removal of old bone. As bone ages, more calcium can deposit in the bone, making it stronger. This prevents fractures and there is no sign that fractures increase later in people who remain on therapy. Rather, women who continue bisphosphonate such as alendronate for 10 years have fewer fractures and better bone density than women on alendronate for just 5 years. This ongoing fracture protection reassures us that bones do not become brittle. Recently, there have been reports of “chalk-stick fractures” of the thigh bone. These are rare fractures of the mid thigh bone, often occurring in patients with osteoporosis. In clinical trials of bisphosphonates, these fractures occur equally in those on bisphosphonate or not on bisphosphonate. Although bisphosphonate reduces the risk of fracture by 40% to 70%, there will continue to be some osteoporosis patients on bisphosphonate treatment who will suffer a fracture. Overall, howe
