Journal Article

Risk factors for fracture among current, persistent users of bisphosphonates

Friess, D., LeBlanc, E. S., O’Malley, C. D., Egbuna, O., Perrin, N. A., Rosales, A. G., Balasubramanian, A.

2015

Overview

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.

• Publisher: Springer London,Springer Nature B.V
• Subject: Aged / Bone Density Conservation Agents - administration & dosage / Bone Density Conservation Agents - therapeutic use / Diphosphonates - administration & dosage / Diphosphonates - therapeutic use / Drug Administration Schedule / Drug therapy / Endocrinology / Female / Follow-Up Studies / Fractures / Humans / Incidence / Male / Medication Adherence - statistics & numerical data / Medicine / Medicine & Public Health / Middle Aged / Oregon - epidemiology / Original Article / Orthopedics / Osteoporosis / Osteoporosis - drug therapy / Osteoporosis - epidemiology / Osteoporotic Fractures - epidemiology / Osteoporotic Fractures - etiology / Osteoporotic Fractures - prevention & control / Retrospective Studies / Rheumatology / Risk Factors / Washington - epidemiology