ArticleBone2016
The association of race/ethnicity and risk of atypical femur fracture among older women receiving oral bisphosphonate therapy.
Article in Bone, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 65 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
65 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Atypical fractures at non-classical sites associated with anti-resorptive therapy: a systematic review.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2024Pooled it
- The Genetics of Atypical Femur Fractures-a Systematic Review.Current osteoporosis reports · 2021Pooled it
- Manual chart review reveals bisphosphonate exposure misclassification in atypical femur fracture patients: auditing medical records in two international cohorts.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- The role of income and educational level as risk factors for atypical femur fractures: A Nationwide Danish Case-Cohort Study with Blinded Radiographic Review.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- [Interpretation of the 2025 Asian Federation of Osteoporosis Societies (AFOS) Clinical Consensus: Atypical femoral fractures in patients with osteoporosis].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026Article
- Risk factors for atypical femur fractures with and without bisphosphonate treatment: a national nested case-control study.JBMR plus · 2026Article
- Association between femoral localized cortical thickening ("beaking" or "flaring") and bisphosphonate duration in glucocorticoid-induced osteoporosis.Journal of bone and mineral metabolism · 2026Article
- Changes in treatment eligibility with race-neutral US FRAX would be modest: estimates using the National Health and Nutrition Examination Survey (NHANES).Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- Atypical Femoral Fractures Induced by Anti-Resorptive Medications.Current osteoporosis reports · 2026Review
- Asian Federation of Osteoporosis Societies 2025 consensus on atypical femoral fractures in patients with osteoporosis.Osteoporosis and sarcopenia · 2025Review
- Epidemiology, Pathophysiology and Management of Atypical Femur Fractures: an Update.Current osteoporosis reports · 2025Review
- Femur geometry influences atypical femoral fracture location.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Article
- Article
- ["Paradoxical fractures": pathological fractures under anti-osteoporotic and antirheumatic treatment].Zeitschrift fur Rheumatologie · 2025Review
- Conservative Treatment With Teriparatide for Symptomatic Incomplete Atypical Femoral Fractures: A Retrospective Observational Study.Geriatric orthopaedic surgery & rehabilitation · 2025Article
- Age- and Gender-Related Femoral Bowing Analysis in the Korean Population and Features for Clinical Applications.Medicina (Kaunas, Lithuania) · 2024Article
- Race-specific FRAX models are evidence-based and support equitable care: a response to the ASBMR Task Force report on Clinical Algorithms for Fracture Risk.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024Article
- Latent metabolic bone disease, skeletal dysplasia and other conditions related to low bone formation among 38 patients with subtrochanteric femoral fractures: a retrospective observational study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024Observational
- Disparities in Osteoporosis Prevention and Care: Understanding Gender, Racial, and Ethnic Dynamics.Current reviews in musculoskeletal medicine · 2024Review
- Prevalence and risk factors for atypical femoral fracture among Lebanese patients with hip and shaft fractures.JBMR plus · 2024Article
5 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
purposeSeveral epidemiologic studies suggest that compared to white women, Asians have a greater propensity to suffer an atypical femur fracture (AFF) while taking bisphosphonate therapy. This study examines the relative risk of AFF following bisphosphonate initiation for Asian compared to white women.
methodsUsing data from a large integrated northern California healthcare delivery system, we examined diaphyseal femur fracture outcomes among women age≥50years old who initiated oral bisphosphonate therapy during 2002-2007. An AFF was defined by the 2013 American Society of Bone and Mineral Research Task Force criteria. The risk of radiographically-confirmed AFF was examined for Asian compared to white women, adjusting for differences in bisphosphonate exposure and other potential risk factors.
resultsAmong 48,390 women (65.3% white, 17.1% Asian) who newly initiated bisphosphonate therapy and were followed for a median of 7.7years, 68 women experienced an AFF. The rate of AFF was 18.7 per 100,000 person-years overall and eight-fold higher among Asian compared to white women (64.2 versus 7.6 per 100,000 person-years). Asians were also more likely to have longer bisphosphonate treatment duration compared to whites (median 3.8 versus 2.7years). The age-adjusted relative hazard for AFF was 8.5 (95% confidence interval 4.9-14.9) comparing Asian to white women, and was only modestly reduced to 6.6 (3.7-11.5) after adjusting for bisphosphonate duration and current use.
conclusionsOur study confirms marked racial disparity in AFF risk that should be further investigated, particularly the mechanisms accounting for this difference. These findings also underscore the need to further examine the association of bisphosphonate duration and AFF in women of Asian race, as well as differential risk across Asian subgroups. In the interim, counseling of Asian women about osteoporosis drug continuation should include consideration of their potentially higher AFF risk.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.