SUMMARY: Bisphosphonate therapy reduces fracture risk but does not eliminate fracture occurrence. We determined the fracture incidence and risk factors for fractures among 14,674 bisphosphonate users in a community setting. Bisphosphonate users remained at risk of fracture, and additional measures to prevent fractures in these patients would be beneficial. INTRODUCTION: Bisphosphonate therapy reduces but does not eliminate fracture occurrence. The incidence of fracture and risk factors for fractures among persistent, current users of bisphosphonates in a community setting have not been well studied. METHODS: We conducted a retrospective cohort study of 14,674 bisphosphonate users in a health maintenance organization. Patients were followed until a 3-month gap in therapy, creating a pool of highly compliant [mean medication possession ratio (MPR) of 94%] current users. We used Cox proportional hazards models to identify risk factors for fractures among these persistent, current users. RESULTS: There were 867 fractures over the period of observation or 3.7 fractures per 100 users per year. Older patients who take multiple medications, have lower bone mineral density, have a history of prior fracture, and suffer from particular comorbidities (i.e., dementia, chronic kidney disease, and rheumatoid arthritis) are at higher risk of fracture while taking bisphosphonates. CONCLUSION: Persistent, current bisphosphonate users remain at risk of fracture, and additional measures to prevent fractures in these patients would be of benefit.
SUMMARY:Bisphosphonate therapy reduces fracture risk but does not eliminate fracture occurrence. We determined the fracture incidence and risk factors for fractures among 14,674 bisphosphonate users in a community setting. Bisphosphonate users remained at risk of fracture, and additional measures to prevent fractures in these patients would be beneficial. INTRODUCTION:Bisphosphonate therapy reduces but does not eliminate fracture occurrence. The incidence of fracture and risk factors for fractures among persistent, current users of bisphosphonates in a community setting have not been well studied. METHODS: We conducted a retrospective cohort study of 14,674 bisphosphonate users in a health maintenance organization. Patients were followed until a 3-month gap in therapy, creating a pool of highly compliant [mean medication possession ratio (MPR) of 94%] current users. We used Cox proportional hazards models to identify risk factors for fractures among these persistent, current users. RESULTS: There were 867 fractures over the period of observation or 3.7 fractures per 100 users per year. Older patients who take multiple medications, have lower bone mineral density, have a history of prior fracture, and suffer from particular comorbidities (i.e., dementia, chronic kidney disease, and rheumatoid arthritis) are at higher risk of fracture while taking bisphosphonates. CONCLUSION: Persistent, current bisphosphonate users remain at risk of fracture, and additional measures to prevent fractures in these patients would be of benefit.
Authors: Erin S LeBlanc; Teresa A Hillier; Kathryn L Pedula; Joanne H Rizzo; Peggy M Cawthon; Howard A Fink; Jane A Cauley; Douglas C Bauer; Dennis M Black; Steven R Cummings; Warren S Browner Journal: Arch Intern Med Date: 2011-09-26
Authors: Adrianne C Feldstein; Derek Weycker; Gregory A Nichols; Gerry Oster; Gabriela Rosales; David L Boardman; Nancy Perrin Journal: Bone Date: 2008-09-26 Impact factor: 4.398
Authors: Daniel Prieto-Alhambra; Aina Pagès-Castellà; Gemma Wallace; M Kassim Javaid; Andrew Judge; Xavier Nogués; Nigel K Arden; Cyrus Cooper; Adolfo Diez-Perez Journal: J Bone Miner Res Date: 2014-01 Impact factor: 6.741
Authors: Alan W Reynolds; Guodong Liu; Paul T Kocis; Jenna N Skowronski; Douglas L Leslie; Edward J Fox Journal: Int J Endocrinol Metab Date: 2018-06-12