The role of antiosteoporotic drugs in fracture healing

  • Christiana Zidrou MD, MSc, PhD, 2nd Orthopaedic Department G. Papageorgiou General Hospital
Keywords: bisphosphonates, denosumab, fracture healing, osteoporotic fractures, teriparatide


This narrative review was carried out to investigate the effect of antiosteoporotic drugs (selective estrogen receptor modulators [SERMs], bisphosphonates, denosumab, teriparatide, romosozumab) in fracture healing process of vertebral, hip and distal radius fractures. The administration of bisphosphonates (BPs) didn’t affect the fracture healing process and clinical results after distal radius and hip fractures. However, there no evidence for vertebral fractures. Denosumab doesn’t seem to delay the process of fracture healing in patients with non-vertebral fractures in a study that was well documented and designed. There no human studies that appreciated the influence of SERMs and romosozumab in fracture healing process. In one study was reported that patients with distal radius fractures who were treated with teriparatide had shorter time of fracture healing, however this was not clinically significant. On one hand, in hip fractures, some recent studies suggested that in patients treated with teriparatide there was better improvement of pain and clinical outcomes of functionality. On the other hand, in vertebral fractures, there was no statistically significantly difference regarding the stability of fractures between teriparatide and control groups. Considering the fact that there is no evidence that antiosteoprotic drugs influence negatively the fracture healing, there is no reason to delay the initiation of antiosteoporotic treatment after the fracture.



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