The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Geoffrey I. Shapiro - One of the best experts on this subject based on the ideXlab platform.
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microrna mediated suppression of the tgf β pathway confers transmissible and reversible cdk4 6 inhibitor resistance
Cell Reports, 2019Co-Authors: Liam Cornell, Seth A. Wander, Tanvi Visal, Nikhil Wagle, Geoffrey I. ShapiroAbstract:Summary CDK4/6 inhibition is now part of the standard armamentarium for patients with estrogen receptor-positive (ER+) breast cancer, so that defining mechanisms of resistance is a pressing issue. Here, we identify increased CDK6 expression as a key determinant of acquired resistance after palbociclib treatment in ER+ breast cancer cells. CDK6 expression is critical for cellular survival during palbociclib exposure. The increased CDK6 expression observed in resistant cells is dependent on TGF-β pathway suppression via miR-432-5p expression. Exosomal miR-432-5p expression mediates the transfer of the resistance phenotype between neighboring cell populations. Levels of miR-432-5p are higher in primary breast cancers demonstrating CDK4/6 resistance compared to those that are sensitive. These data are further confirmed in pre-treatment and post-progression biopsies from a parotid cancer patient who had responded to ribociclib, demonstrating the clinical relevance of this mechanism. Finally, the CDK4/6 inhibitor resistance phenotype is reversible in vitro and in vivo by a prolonged Drug Holiday.
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MicroRNA-Mediated Suppression of the TGF-β Pathway Confers Transmissible and Reversible CDK4/6 Inhibitor Resistance
Elsevier, 2019Co-Authors: Liam Cornell, Seth A. Wander, Tanvi Visal, Nikhil Wagle, Geoffrey I. ShapiroAbstract:Summary: CDK4/6 inhibition is now part of the standard armamentarium for patients with estrogen receptor-positive (ER+) breast cancer, so that defining mechanisms of resistance is a pressing issue. Here, we identify increased CDK6 expression as a key determinant of acquired resistance after palbociclib treatment in ER+ breast cancer cells. CDK6 expression is critical for cellular survival during palbociclib exposure. The increased CDK6 expression observed in resistant cells is dependent on TGF-β pathway suppression via miR-432-5p expression. Exosomal miR-432-5p expression mediates the transfer of the resistance phenotype between neighboring cell populations. Levels of miR-432-5p are higher in primary breast cancers demonstrating CDK4/6 resistance compared to those that are sensitive. These data are further confirmed in pre-treatment and post-progression biopsies from a parotid cancer patient who had responded to ribociclib, demonstrating the clinical relevance of this mechanism. Finally, the CDK4/6 inhibitor resistance phenotype is reversible in vitro and in vivo by a prolonged Drug Holiday. : Cornell et al. demonstrate a mechanism of acquired CDK4/6 inhibitor resistance that is independent of inherent genetic mutations, is conferred through extracellular signaling, and is reversible in vitro and in vivo. Resistance was mediated by exosomal miRNA, causing increased expression of CDK6 to overcome G1 arrest and promote cell survival. Keywords: breast cancer, Drug resistance, targeted therapy, exosomes, CDK6, microRNA, TGF-β, SMAD4, palbociclib, ribocicli
Takumi Hasegawa - One of the best experts on this subject based on the ideXlab platform.
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denosumab related osteonecrosis of the jaw after tooth extraction and the effects of a short Drug Holiday in cancer patients a multicenter retrospective study
Osteoporosis International, 2021Co-Authors: Takumi Hasegawa, Yuka Kojima, Saki Hayashida, Nobuhiro Ueda, Shinichi Yamada, Shinichiro Kato, Eiji Iwata, Mitsuyo Shinohara, I Tojo, Hirokazu NakaharaAbstract:Pre-existing inflammation, corticosteroid therapy, periapical periodontitis, longer duration of denosumab therapy, and female sex were significantly associated with an increased risk of denosumab-related osteonecrosis of the jaw after tooth extraction in patients with cancer on oncologic doses of denosumab. A short Drug Holiday did not protect against this complication. This study retrospectively investigated the relationship between various risk factors, including brief discontinuation of denosumab, and development of denosumab-related osteonecrosis of the jaw (DRONJ) after tooth extraction in patients with cancer who were receiving oncologic doses of this agent. Data were collected on demographic characteristics, duration of denosumab therapy, whether or not denosumab was discontinued before tooth extraction (Drug Holiday), duration of discontinuation, presence of pre-existing inflammation, and whether or not additional surgical procedures were performed. Risk factors for DRONJ after tooth extraction were evaluated by univariate and multivariate analyses. A total of 136 dental extractions were performed in 72 patients (31 men, 41 women) with cancer who were receiving oncologic doses of denosumab. Post-extraction DRONJ was diagnosed in 39 teeth (28.7%) in 25 patients. Tooth extraction was significantly associated with development of DRONJ only in patients with pre-existing inflammation (odds ratio [OR] 243.77), those on corticosteroid therapy (OR 73.50), those with periapical periodontitis (OR 14.13), those who had been taking oncologic doses of denosumab for a longer period (OR 4.69), and in women (OR 1.04). There was no significant difference in the occurrence of DRONJ between patients who had a Drug Holiday before tooth extraction and those who did not. These findings suggest that inflamed teeth should be extracted immediately in patients with cancer who are receiving oncologic doses of denosumab. Drug Holidays have no significant impact on the risk of DRONJ.
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Drug Holiday clinical relevance verification for antiresorptive agents in medication related osteonecrosis cases of the jaw
Journal of Bone and Mineral Metabolism, 2020Co-Authors: Saki Hayashida, Yuka Kojima, Takumi Hasegawa, Nobuhiro Ueda, Souichi Yanamoto, Shigeyuki Fujita, Takahide Komori, Hironori Miyamoto, Yasuyuki Shibuya, Tadaaki KiritaAbstract:Treatment strategies of medication-related osteonecrosis of the jaw (MRONJ) are controversial. Recently, surgical treatment has been reported as superior to nonsurgical treatment, but the contribution discontinued antiresorptive agent use during MRONJ treatment remains unclear. This study aimed to evaluate the efficacy of Drug Holidays and treatment strategies in MRONJ cases. Four-hundred and twenty-seven patients with MRONJ treated at nine hospitals from 2009 to 2017 were included in this multicenter retrospective study. Multivariate Cox regression analysis showed that the primary disease (osteoporosis or malignant tumor), diabetes, serum albumin, and treatment method (surgical or nonsurgical) were significantly correlated with the cure rate. The cumulative 1-year cure rates in the surgical and nonsurgical treatment groups were 64.7% and 18.2%, respectively. However, discontinuing antiresorptive agents did not influence the treatment outcome in the cohort overall, or in 230 patients after performing propensity score matching among the discontinuation and continuation groups. When stratifying by treatment method, antiresorptive agent discontinuation significantly increased the cure rate in patients with osteoporosis who underwent nonsurgical treatment. In patients with malignant tumors undergoing nonsurgical therapy, discontinuing the antiresorptive agent was associated with a better treatment outcome, but not with statistical significance. In contrast, Drug Holidays showed no effect on improving outcomes in patients with both osteoporosis and malignant tumors who underwent surgical therapy. Thus, regardless of the primary disease, discontinuing antiresorptive agents during treatment for MRONJ may not be necessary and may be helpful in some cases. Future prospective trials should examine this question further.
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a multicenter retrospective study of the risk factors associated with medication related osteonecrosis of the jaw after tooth extraction in patients receiving oral bisphosphonate therapy can primary wound closure and a Drug Holiday really prevent mro
Osteoporosis International, 2017Co-Authors: Takumi Hasegawa, Yuka Kojima, Nobuhiro Ueda, Akiko Kawakita, R Funahara, Akira Tachibana, Masaki Kobayashi, E Kondou, Daisuke Takeda, S SatoAbstract:Root amputation, extraction of a single tooth, bone loss or severe tooth mobility, and an unclosed wound were significantly associated with increased risk of developing medication-related osteonecrosis of the jaw (MRONJ). We recommend a minimally traumatic extraction technique, removal of any bone edges, and mucosal wound closure as standard procedures in patients receiving bisphosphonates. Osteonecrosis of the jaws can occur following tooth extraction in patients receiving bisphosphonate Drugs. Various strategies for minimizing the risk of MRONJ have been advanced, but no studies have comprehensively analyzed the efficacy of factors such as primary wound closure, demographics, and Drug Holidays in reducing its incidence. The purpose of this study was to retrospectively investigate the relationships between these various risk factors after tooth extraction in patients receiving oral bisphosphonate therapy. Risk factors for MRONJ after tooth extraction were evaluated using univariate and multivariate analysis. All patients were investigated with regard to demographics; type and duration of oral bisphosphonate use; whether they underwent a discontinuation of oral bisphosphonates before tooth extraction (Drug Holiday), and the duration of such discontinuation; and whether any additional surgical procedures (e.g., incision, removal of bone edges, root amputation) were performed. We found that root amputation (OR = 6.64), extraction of a single tooth (OR = 3.70), bone loss or severe tooth mobility (OR = 3.60), and an unclosed wound (OR = 2.51) were significantly associated with increased risk of developing MRONJ. We recommend a minimally traumatic extraction technique, removal of any bone edges, and mucosal wound closure as standard procedures in patients receiving bisphosphonates. We find no evidence supporting the efficacy of a pre-extraction short-term Drug Holiday from oral bisphosphonates in reducing the risk of MRONJ.
Yuka Kojima - One of the best experts on this subject based on the ideXlab platform.
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denosumab related osteonecrosis of the jaw after tooth extraction and the effects of a short Drug Holiday in cancer patients a multicenter retrospective study
Osteoporosis International, 2021Co-Authors: Takumi Hasegawa, Yuka Kojima, Saki Hayashida, Nobuhiro Ueda, Shinichi Yamada, Shinichiro Kato, Eiji Iwata, Mitsuyo Shinohara, I Tojo, Hirokazu NakaharaAbstract:Pre-existing inflammation, corticosteroid therapy, periapical periodontitis, longer duration of denosumab therapy, and female sex were significantly associated with an increased risk of denosumab-related osteonecrosis of the jaw after tooth extraction in patients with cancer on oncologic doses of denosumab. A short Drug Holiday did not protect against this complication. This study retrospectively investigated the relationship between various risk factors, including brief discontinuation of denosumab, and development of denosumab-related osteonecrosis of the jaw (DRONJ) after tooth extraction in patients with cancer who were receiving oncologic doses of this agent. Data were collected on demographic characteristics, duration of denosumab therapy, whether or not denosumab was discontinued before tooth extraction (Drug Holiday), duration of discontinuation, presence of pre-existing inflammation, and whether or not additional surgical procedures were performed. Risk factors for DRONJ after tooth extraction were evaluated by univariate and multivariate analyses. A total of 136 dental extractions were performed in 72 patients (31 men, 41 women) with cancer who were receiving oncologic doses of denosumab. Post-extraction DRONJ was diagnosed in 39 teeth (28.7%) in 25 patients. Tooth extraction was significantly associated with development of DRONJ only in patients with pre-existing inflammation (odds ratio [OR] 243.77), those on corticosteroid therapy (OR 73.50), those with periapical periodontitis (OR 14.13), those who had been taking oncologic doses of denosumab for a longer period (OR 4.69), and in women (OR 1.04). There was no significant difference in the occurrence of DRONJ between patients who had a Drug Holiday before tooth extraction and those who did not. These findings suggest that inflamed teeth should be extracted immediately in patients with cancer who are receiving oncologic doses of denosumab. Drug Holidays have no significant impact on the risk of DRONJ.
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periosteal reaction as a risk factor for poor outcomes after surgical treatment for medication related osteonecrosis of the jaw a retrospective analysis of 205 surgeries
Journal of Oral and Maxillofacial Surgery Medicine and Pathology, 2020Co-Authors: Yumi Kawaoka, Yuka Kojima, Shunsuke Sawada, Saki Hayashida, Hirokazu Yutori, Sakiko Soutome, Madoka Funahara, Maho Murata, Masahiro UmedaAbstract:Abstract Objective To investigate the relationship between the presence of periosteal reaction and the outcome of surgical treatment for medication-related osteonecrosis of the jaw (MRONJ) and determine the appropriate bone resection method for periosteal reaction. Methods We retrospectively reviewed the medical records of 163 patients who underwent 205 surgeries for MRONJ in the Department of Dentistry and Oral Surgery, Kansai Medical University Hospital and the Department of Oral and Maxillofacial Surgery, Nagasaki University Hospital. The evaluated parameters were as follows: patient age and sex, site of involvement, stage, trigger, primary disease, type of antiresorptive agent, duration of antiresorptive therapy, presence/absence of preoperative Drug Holiday, use of corticosteroids, presence/absence of diabetes, leukocyte count, serum albumin and creatinine levels, surgery type, preoperative computed tomography (CT) findings, and treatment outcome. Preoperative CT parameters included separation of the sequestrum, osteosclerosis, and periosteal reaction. The correlation between each variable and the treatment outcome was analyzed using Cox regression analyses. Results The 1-year cumulative cure rate was 81.5%. Multivariate analysis revealed that malignancy (primary disease), a low average albumin value, and the presence of periosteal reaction were independent risk factors for a poor treatment outcome. Complete healing was achieved in 10 of 12 cases where the bone showing periosteal reaction was surgically resected, whereas complete healing was not observed in 22 of 36 cases with residual periosteal reaction after surgery. Conclusions Preoperative periosteal reaction is a predictor of a poor outcome after surgical treatment for MRONJ. Clinicians should consider complete resection of the bone showing periosteal reaction.
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Drug Holiday clinical relevance verification for antiresorptive agents in medication related osteonecrosis cases of the jaw
Journal of Bone and Mineral Metabolism, 2020Co-Authors: Saki Hayashida, Yuka Kojima, Takumi Hasegawa, Nobuhiro Ueda, Souichi Yanamoto, Shigeyuki Fujita, Takahide Komori, Hironori Miyamoto, Yasuyuki Shibuya, Tadaaki KiritaAbstract:Treatment strategies of medication-related osteonecrosis of the jaw (MRONJ) are controversial. Recently, surgical treatment has been reported as superior to nonsurgical treatment, but the contribution discontinued antiresorptive agent use during MRONJ treatment remains unclear. This study aimed to evaluate the efficacy of Drug Holidays and treatment strategies in MRONJ cases. Four-hundred and twenty-seven patients with MRONJ treated at nine hospitals from 2009 to 2017 were included in this multicenter retrospective study. Multivariate Cox regression analysis showed that the primary disease (osteoporosis or malignant tumor), diabetes, serum albumin, and treatment method (surgical or nonsurgical) were significantly correlated with the cure rate. The cumulative 1-year cure rates in the surgical and nonsurgical treatment groups were 64.7% and 18.2%, respectively. However, discontinuing antiresorptive agents did not influence the treatment outcome in the cohort overall, or in 230 patients after performing propensity score matching among the discontinuation and continuation groups. When stratifying by treatment method, antiresorptive agent discontinuation significantly increased the cure rate in patients with osteoporosis who underwent nonsurgical treatment. In patients with malignant tumors undergoing nonsurgical therapy, discontinuing the antiresorptive agent was associated with a better treatment outcome, but not with statistical significance. In contrast, Drug Holidays showed no effect on improving outcomes in patients with both osteoporosis and malignant tumors who underwent surgical therapy. Thus, regardless of the primary disease, discontinuing antiresorptive agents during treatment for MRONJ may not be necessary and may be helpful in some cases. Future prospective trials should examine this question further.
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a multicenter retrospective study of the risk factors associated with medication related osteonecrosis of the jaw after tooth extraction in patients receiving oral bisphosphonate therapy can primary wound closure and a Drug Holiday really prevent mro
Osteoporosis International, 2017Co-Authors: Takumi Hasegawa, Yuka Kojima, Nobuhiro Ueda, Akiko Kawakita, R Funahara, Akira Tachibana, Masaki Kobayashi, E Kondou, Daisuke Takeda, S SatoAbstract:Root amputation, extraction of a single tooth, bone loss or severe tooth mobility, and an unclosed wound were significantly associated with increased risk of developing medication-related osteonecrosis of the jaw (MRONJ). We recommend a minimally traumatic extraction technique, removal of any bone edges, and mucosal wound closure as standard procedures in patients receiving bisphosphonates. Osteonecrosis of the jaws can occur following tooth extraction in patients receiving bisphosphonate Drugs. Various strategies for minimizing the risk of MRONJ have been advanced, but no studies have comprehensively analyzed the efficacy of factors such as primary wound closure, demographics, and Drug Holidays in reducing its incidence. The purpose of this study was to retrospectively investigate the relationships between these various risk factors after tooth extraction in patients receiving oral bisphosphonate therapy. Risk factors for MRONJ after tooth extraction were evaluated using univariate and multivariate analysis. All patients were investigated with regard to demographics; type and duration of oral bisphosphonate use; whether they underwent a discontinuation of oral bisphosphonates before tooth extraction (Drug Holiday), and the duration of such discontinuation; and whether any additional surgical procedures (e.g., incision, removal of bone edges, root amputation) were performed. We found that root amputation (OR = 6.64), extraction of a single tooth (OR = 3.70), bone loss or severe tooth mobility (OR = 3.60), and an unclosed wound (OR = 2.51) were significantly associated with increased risk of developing MRONJ. We recommend a minimally traumatic extraction technique, removal of any bone edges, and mucosal wound closure as standard procedures in patients receiving bisphosphonates. We find no evidence supporting the efficacy of a pre-extraction short-term Drug Holiday from oral bisphosphonates in reducing the risk of MRONJ.
Nobuhiro Ueda - One of the best experts on this subject based on the ideXlab platform.
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denosumab related osteonecrosis of the jaw after tooth extraction and the effects of a short Drug Holiday in cancer patients a multicenter retrospective study
Osteoporosis International, 2021Co-Authors: Takumi Hasegawa, Yuka Kojima, Saki Hayashida, Nobuhiro Ueda, Shinichi Yamada, Shinichiro Kato, Eiji Iwata, Mitsuyo Shinohara, I Tojo, Hirokazu NakaharaAbstract:Pre-existing inflammation, corticosteroid therapy, periapical periodontitis, longer duration of denosumab therapy, and female sex were significantly associated with an increased risk of denosumab-related osteonecrosis of the jaw after tooth extraction in patients with cancer on oncologic doses of denosumab. A short Drug Holiday did not protect against this complication. This study retrospectively investigated the relationship between various risk factors, including brief discontinuation of denosumab, and development of denosumab-related osteonecrosis of the jaw (DRONJ) after tooth extraction in patients with cancer who were receiving oncologic doses of this agent. Data were collected on demographic characteristics, duration of denosumab therapy, whether or not denosumab was discontinued before tooth extraction (Drug Holiday), duration of discontinuation, presence of pre-existing inflammation, and whether or not additional surgical procedures were performed. Risk factors for DRONJ after tooth extraction were evaluated by univariate and multivariate analyses. A total of 136 dental extractions were performed in 72 patients (31 men, 41 women) with cancer who were receiving oncologic doses of denosumab. Post-extraction DRONJ was diagnosed in 39 teeth (28.7%) in 25 patients. Tooth extraction was significantly associated with development of DRONJ only in patients with pre-existing inflammation (odds ratio [OR] 243.77), those on corticosteroid therapy (OR 73.50), those with periapical periodontitis (OR 14.13), those who had been taking oncologic doses of denosumab for a longer period (OR 4.69), and in women (OR 1.04). There was no significant difference in the occurrence of DRONJ between patients who had a Drug Holiday before tooth extraction and those who did not. These findings suggest that inflamed teeth should be extracted immediately in patients with cancer who are receiving oncologic doses of denosumab. Drug Holidays have no significant impact on the risk of DRONJ.
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Drug Holiday clinical relevance verification for antiresorptive agents in medication related osteonecrosis cases of the jaw
Journal of Bone and Mineral Metabolism, 2020Co-Authors: Saki Hayashida, Yuka Kojima, Takumi Hasegawa, Nobuhiro Ueda, Souichi Yanamoto, Shigeyuki Fujita, Takahide Komori, Hironori Miyamoto, Yasuyuki Shibuya, Tadaaki KiritaAbstract:Treatment strategies of medication-related osteonecrosis of the jaw (MRONJ) are controversial. Recently, surgical treatment has been reported as superior to nonsurgical treatment, but the contribution discontinued antiresorptive agent use during MRONJ treatment remains unclear. This study aimed to evaluate the efficacy of Drug Holidays and treatment strategies in MRONJ cases. Four-hundred and twenty-seven patients with MRONJ treated at nine hospitals from 2009 to 2017 were included in this multicenter retrospective study. Multivariate Cox regression analysis showed that the primary disease (osteoporosis or malignant tumor), diabetes, serum albumin, and treatment method (surgical or nonsurgical) were significantly correlated with the cure rate. The cumulative 1-year cure rates in the surgical and nonsurgical treatment groups were 64.7% and 18.2%, respectively. However, discontinuing antiresorptive agents did not influence the treatment outcome in the cohort overall, or in 230 patients after performing propensity score matching among the discontinuation and continuation groups. When stratifying by treatment method, antiresorptive agent discontinuation significantly increased the cure rate in patients with osteoporosis who underwent nonsurgical treatment. In patients with malignant tumors undergoing nonsurgical therapy, discontinuing the antiresorptive agent was associated with a better treatment outcome, but not with statistical significance. In contrast, Drug Holidays showed no effect on improving outcomes in patients with both osteoporosis and malignant tumors who underwent surgical therapy. Thus, regardless of the primary disease, discontinuing antiresorptive agents during treatment for MRONJ may not be necessary and may be helpful in some cases. Future prospective trials should examine this question further.
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a multicenter retrospective study of the risk factors associated with medication related osteonecrosis of the jaw after tooth extraction in patients receiving oral bisphosphonate therapy can primary wound closure and a Drug Holiday really prevent mro
Osteoporosis International, 2017Co-Authors: Takumi Hasegawa, Yuka Kojima, Nobuhiro Ueda, Akiko Kawakita, R Funahara, Akira Tachibana, Masaki Kobayashi, E Kondou, Daisuke Takeda, S SatoAbstract:Root amputation, extraction of a single tooth, bone loss or severe tooth mobility, and an unclosed wound were significantly associated with increased risk of developing medication-related osteonecrosis of the jaw (MRONJ). We recommend a minimally traumatic extraction technique, removal of any bone edges, and mucosal wound closure as standard procedures in patients receiving bisphosphonates. Osteonecrosis of the jaws can occur following tooth extraction in patients receiving bisphosphonate Drugs. Various strategies for minimizing the risk of MRONJ have been advanced, but no studies have comprehensively analyzed the efficacy of factors such as primary wound closure, demographics, and Drug Holidays in reducing its incidence. The purpose of this study was to retrospectively investigate the relationships between these various risk factors after tooth extraction in patients receiving oral bisphosphonate therapy. Risk factors for MRONJ after tooth extraction were evaluated using univariate and multivariate analysis. All patients were investigated with regard to demographics; type and duration of oral bisphosphonate use; whether they underwent a discontinuation of oral bisphosphonates before tooth extraction (Drug Holiday), and the duration of such discontinuation; and whether any additional surgical procedures (e.g., incision, removal of bone edges, root amputation) were performed. We found that root amputation (OR = 6.64), extraction of a single tooth (OR = 3.70), bone loss or severe tooth mobility (OR = 3.60), and an unclosed wound (OR = 2.51) were significantly associated with increased risk of developing MRONJ. We recommend a minimally traumatic extraction technique, removal of any bone edges, and mucosal wound closure as standard procedures in patients receiving bisphosphonates. We find no evidence supporting the efficacy of a pre-extraction short-term Drug Holiday from oral bisphosphonates in reducing the risk of MRONJ.
Pauline M Camacho - One of the best experts on this subject based on the ideXlab platform.
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osteoporotic fractures during bisphosphonate Drug Holiday
Endocrine Practice, 2017Co-Authors: Brittany Bindon, William Adams, Neelam Balasubramanian, Jasmin Sandhu, Pauline M CamachoAbstract:ABSTRACT Objective: Bisphosphonate (BP) Drug Holidays are recommended to lower the risk of rare adverse events, such as atypical femoral fractures and osteonecrosis of the jaw. However, there are m...
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long term follow up of patients on Drug Holiday from bisphosphonates real world setting
Endocrine Practice, 2013Co-Authors: Maguy Chiha, Lauren Myers, Caroline A Ball, James Sinacore, Pauline M CamachoAbstract:Objective: Atypical femoral fractures and osteoporosis of the jaw have been associated with prolonged bisphosphonate therapy for postmenopausal osteoporosis. American Association of Clinical Endocrinologists guidelines suggest a Drug Holiday after 4 to 5 years of bisphosphonate treatment for moderate-risk patients and 10 years for high-risk patients, but there are minimal data on safe Holiday durations. A recent U. S. Food and Drug Administration perspective suggests a treatment duration of 3 to 5 years. Our aim was to describe a group of patients on Drug Holiday and identify fracture risk.Methods: A retrospective chart review was conducted of 209 patients who started a bisphosphonate Drug Holiday between 2005 and 2010. Collected data included bone mineral density (BMD), markers of bone turnover, vitamin D status, and clinical and radiographic reports of fractures.Results: Eleven of 209 patients (5.2%) developed a fracture. Their mean age was 69.36 years (±15.58), and the mean lumbar spine and femoral nec...
