{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T15:11:28Z","timestamp":1772118688396,"version":"3.50.1"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2023,4,27]],"date-time":"2023-04-27T00:00:00Z","timestamp":1682553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011649","name":"Japan Orthopaedics and Traumatology Foundation","doi-asserted-by":"publisher","award":["468"],"award-info":[{"award-number":["468"]}],"id":[{"id":"10.13039\/501100011649","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["asbmr.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JBMR Plus"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Patients on bone\u2010modifying agents (BMAs) for bone metastases are at risk of atypical femoral fractures (AFFs), which can lead to a sudden deterioration in performance status. In this study, we sought to determine the prevalence of radiographic precursory signs of AFF in patients on oncologic BMAs. Forty\u2010two patients (23 men, 19 women; mean age 68.8\u2009\u00b1\u200910.0\u2009years) on oncologic BMAs (zoledronate for &gt;3\u2009years and\/or denosumab for &gt;1\u2009year) and without clinical symptoms were enrolled between 2019 and 2021. All patients were receiving denosumab at enrollment and 5 had previously used zoledronate. The mean duration of BMA use was 31.2\u2009\u00b1\u200918.5\u2009months. Radiographs of both femurs were screened for precursory signs of AFF (e.g., thickening of the lateral cortex). The patients were divided into two groups according to thickening status and compared by duration of BMA use. They were also divided into three groups by duration of BMA use (12\u201323\u2009months,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200918; 24\u201359\u2009months,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200919; \u226560\u2009months,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20095), and the prevalence of apparent thickenings was examined. As a result, 18 patients (42.9%) showed minute local or diffuse thickening and 10 (23.8%) showed apparent local thickening. The duration of BMA use was significantly longer in patients with apparent thickening than in those without (47.3\u2009\u00b1\u200923.6\u2009months [\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200910] versus 26.2\u2009\u00b1\u200913.5\u2009months [\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200932];\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05). The prevalence of apparent thickening increased with increasing duration of BMA use (12\u201323\u2009months, 5.6%; 24\u201359\u2009months, 31.6%; \u226560\u2009months, 60.0%). In conclusion, radiographic precursory signs of AFF are common in patients on oncologic BMAs. Radiographic screening for AFF could be relevant in patients who have been on long\u2010term oncologic BMAs, even if asymptomatic. \u00a9 2023 The Authors.\n                    <jats:italic>JBMR Plus<\/jats:italic>\n                    published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.\n                  <\/jats:p>","DOI":"10.1002\/jbm4.10749","type":"journal-article","created":{"date-parts":[[2023,4,28]],"date-time":"2023-04-28T00:11:25Z","timestamp":1682640685000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Prevalence of Precursory Signs of Atypical Femoral Fractures in Patients Receiving Bone\u2010Modifying Agents for Bone Metastases: A Cross\u2010Sectional Study"],"prefix":"10.1093","volume":"7","author":[{"given":"Takumi","family":"Kaku","sequence":"first","affiliation":[{"name":"Department of Orthopaedic and Spinal Surgery Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5229-4894","authenticated-orcid":false,"given":"Yoto","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Trauma Research Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shingo","family":"Sato","sequence":"additional","affiliation":[{"name":"Center for Innovative Cancer Treatment, Tokyo Medical and Dental University Medical Hospital  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirotaka","family":"Koyanagi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Spinal Surgery Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuki","family":"Funauchi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Spinal Surgery Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Hirai","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Spinal Surgery Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masato","family":"Yuasa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Spinal Surgery Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Matsukura","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Spinal Surgery Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshitaka","family":"Yoshii","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Spinal Surgery Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsuyoshi","family":"Nakagawa","sequence":"additional","affiliation":[{"name":"Department of Breast Surgery Tokyo Medical and Dental University Medical Hospital  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Miyake","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Okawa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Spinal Surgery Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,4,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2020.07.019"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.4391"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.11701"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.05.116"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-11-3310"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)62344-6"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-013-2022-1"},{"key":"e_1_2_11_9_1","unstructured":"Center for Cancer Control and Information Services: National Cancer Center Cancer statistics in Japan;2021.https:\/\/ganjoho.jp\/public\/qa_links\/report\/statistics\/2021_en.html."},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0278-2391(03)00720-1"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2003.09.001"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2004.02.004"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.02.8670"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.253"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbo.2020.100301"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-019-6236-6"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2016-0192"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbo.2019.100259"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.01199"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.2818"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.1998"},{"key":"e_1_2_11_22_1","first-page":"51","volume-title":"Introductory Chemistry. 6th Ed in SI Units","author":"Nivaldo JT","year":"2018"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-0952"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e318172841c"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2012.02.632"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00776-014-0572-9"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.N.00075"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2014.08.037"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2017.09.023"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2014.08.001"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2018.02.015"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2019.09.004"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1177\/20420188211049619"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-017-4169-y"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00774-014-0606-6"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.3109\/17453674.2014.885355"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2013.12.027"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2020.115453"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-021-02896-3"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgz295"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2017.08.003"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.3337"}],"container-title":["JBMR Plus"],"original-title":[],"language":"en","deposited":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T09:58:08Z","timestamp":1710410288000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jbmrplus\/article\/7\/7\/n\/a\/7612281"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,27]]},"references-count":41,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["10.1002\/jbm4.10749"],"URL":"https:\/\/doi.org\/10.1002\/jbm4.10749","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1002\/JBM4.10749\/v2\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1002\/JBM4.10749\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1002\/JBM4.10749\/v2\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1002\/JBM4.10749\/v3\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1002\/JBM4.10749\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1002\/JBM4.10749\/v3\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1002\/JBM4.10749\/v2\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1002\/JBM4.10749\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1002\/JBM4.10749\/v3\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1002\/JBM4.10749\/v1\/decision1","asserted-by":"object"}]},"ISSN":["2473-4039","2473-4039"],"issn-type":[{"value":"2473-4039","type":"print"},{"value":"2473-4039","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,27]]},"assertion":[{"value":"2022-10-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e10749"}}