Atypical fracture with denosumab

A report of atypical fractures with denosumab has prompted calls for caution before prescribing the drug in patients who have previously received long term bisphosphonate therapy.

Rheumatologists at a fracture clinic in Belfast have reported the case of a 59-year old woman with osteoporosis who had an atypical  fracture of her right femur three months after an injection of denosumab.

The woman had previously had five years of treatment with alendronate, but this had been discontinued more than 12 years before the fracture.  The atypical fracture occurred within three months of the