{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T19:13:04Z","timestamp":1790881984203,"version":"4.1.0"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>A 56-year-old woman presented with bilateral hip pain status postmechanical fall. Imaging confirmed bilateral AFFs with lateral cortical beaking. The patient was found to be on a calcitonin gene\u2013related peptide (CGRP) antagonist, Erenumab, for treatment of recurrent migraines. CGRP is a neuropeptide and vasodilator produced by neurons in both the central and peripheral nervous system. She was treated with bilateral femoral intramedullary nails, followed by postoperative rehabilitation with physical therapy and outpatient follow-up visits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Erenumab is a CGRP antagonist, which increases bone formation, and may be associated with atypical femur fractures. Further investigations are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.25.00148","type":"journal-article","created":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T18:02:10Z","timestamp":1752170530000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Calcitonin Gene\u2013Related Peptide Antagonist Use and Atypical Femur Fractures"],"prefix":"10.2106","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-0851-3994","authenticated-orcid":false,"given":"Kenneth","family":"Choy","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Northwell Health Huntington Hospital, Huntington, New York"},{"name":"Department of Orthopaedic Surgery, Zucker School of Medicine at Hofstra\/Northwell Health, Hempstead, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9569-6920","authenticated-orcid":false,"given":"Jason J","family":"McDonald","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Northwell Health Huntington Hospital, Huntington, New York"},{"name":"Department of Orthopaedic Surgery, Zucker School of Medicine at Hofstra\/Northwell Health, Hempstead, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2665-3096","authenticated-orcid":false,"given":"Matthew","family":"Geiselmann","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Northwell Health Huntington Hospital, Huntington, New York"},{"name":"Department of Orthopaedic Surgery, Zucker School of Medicine at Hofstra\/Northwell Health, Hempstead, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Daubs","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Northwell Health Huntington Hospital, Huntington, New York"},{"name":"Department of Orthopaedic Surgery, Zucker School of Medicine at Hofstra\/Northwell Health, Hempstead, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,7]]},"reference":[{"issue":"4","key":"bib1-20250710","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1186\/ar4013","article-title":"Atypical subtrochanteric femoral shaft fractures: role for mechanics and bone quality","volume":"14","author":"Van der Meulen","year":"2012","journal-title":"Arthritis Res Ther."},{"issue":"1","key":"bib2-20250710","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1186\/s13256-023-03764-w","article-title":"Denosumab-induced hypocalcemia post bariatric surgery\u2014a severe and protracted course: a case report","volume":"17","author":"Awang","year":"2023","journal-title":"J Med Case Rep."},{"issue":"5","key":"bib3-20250710","doi-asserted-by":"crossref","first-page":"838","DOI":"10.3390\/biom13050838","article-title":"Research progress in calcitonin gene-related Peptide and bone repair","volume":"13","author":"Wang","year":"2023","journal-title":"Biomolecules."},{"issue":"1","key":"bib4-20250710","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3109\/17453674.2013.859423","article-title":"Denosumab and atypical femoral fractures","volume":"85","author":"Aspenberg","year":"2014","journal-title":"Acta Orthop."},{"issue":"6","key":"bib5-20250710","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1046\/j.1365-2613.2000.00176.x","article-title":"Calcitonin and calcitonin receptors: bone and beyond","volume":"81","author":"Pondel","year":"2000","journal-title":"Int J Exp Pathol."},{"issue":"3","key":"bib6-20250710","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1097\/BOR.0000000000000169","article-title":"Current approaches to osteoporosis treatment","volume":"27","author":"Lim","year":"2015","journal-title":"Curr Opin Rheumatol."},{"issue":"8","key":"bib7-20250710","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1056\/NEJMoa0809493","article-title":"Denosumab for prevention of fractures in postmenopausal women with osteoporosis","volume":"361","author":"Cummings","year":"2009","journal-title":"New Engl J Med."},{"issue":"1","key":"bib8-20250710","doi-asserted-by":"crossref","first-page":"152","DOI":"10.3390\/jcm10010152","article-title":"Denosumab discontinuation and the rebound phenomenon: a narrative review","volume":"10","author":"Anastasilakis","year":"2021","journal-title":"J Clin Med."},{"issue":"2","key":"bib9-20250710","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1111\/bcp.12618","article-title":"CGRP receptor antagonists and antibodies against CGRP and its receptor in migraine treatment","volume":"80","author":"Edvinsson","year":"2015","journal-title":"Br J Clin Pharmacol."},{"key":"bib10-20250710","doi-asserted-by":"crossref","first-page":"103025","DOI":"10.1016\/j.ebiom.2020.103025","article-title":"No pain, no gain: will migraine therapies increase bone loss and impair fracture healing?","volume":"60","author":"Kacena","year":"2020","journal-title":"EBioMedicine."},{"issue":"3","key":"bib11-20250710","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.pharmthera.2009.09.003","article-title":"The role of CGRP in the pathophysiology of migraine and efficacy of CGRP receptor antagonists as acute antimigraine drugs","volume":"124","author":"Villal\u00f3n","year":"2009","journal-title":"Pharmacol Ther."},{"issue":"1","key":"bib12-20250710","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.tips.2018.11.003","article-title":"CGRP\/CGRP receptor antibodies: potential adverse effects due to blockade of neovascularization","volume":"40","author":"Majima","year":"2019","journal-title":"Trends Pharmacol Sci."},{"issue":"11","key":"bib13-20250710","doi-asserted-by":"crossref","first-page":"2267","DOI":"10.1002\/jbmr.253","article-title":"Atypical subtrochanteric and diaphyseal femoral fractures: report of a task force of the American society for bone and mineral Research","volume":"25","author":"Shane","year":"2010","journal-title":"J Bone Mineral Res."},{"issue":"6","key":"bib15-20250710","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.1002\/jor.25474","article-title":"Inhibition of CGRP signaling impairs fracture healing in mice","volume":"41","author":"Wee","year":"2023","journal-title":"J Orthop Res."},{"key":"bib16-20250710","doi-asserted-by":"crossref","first-page":"115646","DOI":"10.1016\/j.bone.2020.115646","article-title":"Effects of CGRP receptor antagonism on glucose and bone metabolism in mice with diet-induced obesity","volume":"143","author":"K\u00f6hli","year":"2021","journal-title":"Bone."},{"issue":"23","key":"bib17-20250710","doi-asserted-by":"crossref","first-page":"2059","DOI":"10.2106\/JBJS.22.00363","article-title":"Incomplete diaphyseal atypical femoral fracture due to increased anterolateral bowing: treatment with corrective osteotomy and intramedullary nailing with augmented plate fixation","volume":"104","author":"Yoon","year":"2022","journal-title":"J Bone Joint Surg Am."}],"container-title":["JBJS Case Connector"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.25.00148","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:29:29Z","timestamp":1787750969000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.25.00148"}},"subtitle":["A Case Report"],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":16,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.cc.25.00148","relation":{},"ISSN":["2160-3251"],"issn-type":[{"value":"2160-3251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]}}}