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Persistent bisphosphonate use and the risk of osteoporotic fractures in clinical practice: a database analysis study
ABSTRACT Objective: This study aimed to investigate the association between persistent use of bisphosphonates and the risk of osteoporotic fractures in clinical practice. Methods: Data were obtained from the PHARMO Record Linkage System, which includes, among other databases, drug-dispensing records...
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| Published in: | Current medical research and opinion 2006-09, Vol.22 (9), p.1757-1764 |
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| container_issue | 9 |
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| container_title | Current medical research and opinion |
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| creator | van den Boogaard, C. H. A. Breekveldt‐Postma, N. S. Borggreve, S. E. Goettsch, W. G. Herings, R. M. C. |
| description | ABSTRACT
Objective: This study aimed to investigate the association between persistent use of bisphosphonates and the risk of osteoporotic fractures in clinical practice.
Methods: Data were obtained from the PHARMO Record Linkage System, which includes, among other databases, drug-dispensing records from community pharmacies linked to hospital discharge records of more than two million subjects in defined areas in the Netherlands. Persistence with bisphosphonate therapy was assessed during a period of 3 years. A nested matched case control study (cases:controls = 1:10) was performed to study the association between persistent bisphosphonate use and hospitalisation for osteoporotic fractures and analysed by conditional logistic regression analysis. The analyses were adjusted for patient characteristics such as previous hospitalisations for fractures, co-morbidity and co-medication.
Results: 14 760 new female users of bisphosphonates were identified of which 541 women had a hospitalisation for osteoporotic fracture after start of bisphosphonate treatment (1–3 years follow-up). One-year persistence rates increased from 33% with alendronate daily to 48% with alendronate weekly, an increase of 15%. Similar results were obtained with risedronate daily and weekly. One year persistent use of bisphosphonates resulted in a statistical significant 26% lower fracture rate (OR 0.74; 95%CI 0.57–0.95) whereas 2 year persistent use resulted in a 32% lower rate (OR 0.68; 95%CI 0.47–0.96).
Conclusions: Persistent use of bisphosphonates decreases the risk of osteoporotic fractures in clinical practice. Approximately 6% of fractures among users of bisphosphonates could be prevented if persistence was improved by 20%. However, current persistence with bisphosphonate therapy is suboptimal and strategies that further increase persistence are likely to further prevent the number of fractures. |
| doi_str_mv | 10.1185/030079906X132370 |
| format | article |
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Objective: This study aimed to investigate the association between persistent use of bisphosphonates and the risk of osteoporotic fractures in clinical practice.
Methods: Data were obtained from the PHARMO Record Linkage System, which includes, among other databases, drug-dispensing records from community pharmacies linked to hospital discharge records of more than two million subjects in defined areas in the Netherlands. Persistence with bisphosphonate therapy was assessed during a period of 3 years. A nested matched case control study (cases:controls = 1:10) was performed to study the association between persistent bisphosphonate use and hospitalisation for osteoporotic fractures and analysed by conditional logistic regression analysis. The analyses were adjusted for patient characteristics such as previous hospitalisations for fractures, co-morbidity and co-medication.
Results: 14 760 new female users of bisphosphonates were identified of which 541 women had a hospitalisation for osteoporotic fracture after start of bisphosphonate treatment (1–3 years follow-up). One-year persistence rates increased from 33% with alendronate daily to 48% with alendronate weekly, an increase of 15%. Similar results were obtained with risedronate daily and weekly. One year persistent use of bisphosphonates resulted in a statistical significant 26% lower fracture rate (OR 0.74; 95%CI 0.57–0.95) whereas 2 year persistent use resulted in a 32% lower rate (OR 0.68; 95%CI 0.47–0.96).
Conclusions: Persistent use of bisphosphonates decreases the risk of osteoporotic fractures in clinical practice. Approximately 6% of fractures among users of bisphosphonates could be prevented if persistence was improved by 20%. However, current persistence with bisphosphonate therapy is suboptimal and strategies that further increase persistence are likely to further prevent the number of fractures.</description><identifier>ISSN: 0300-7995</identifier><identifier>EISSN: 1473-4877</identifier><identifier>DOI: 10.1185/030079906X132370</identifier><identifier>PMID: 16968579</identifier><identifier>CODEN: CMROCX</identifier><language>eng</language><publisher>England: Informa UK Ltd</publisher><subject>Aged ; Aged, 80 and over ; Bisphosphonates ; Case-Control Studies ; Diphosphonates - administration & dosage ; Dosing regimen ; Drug Administration Schedule ; Female ; Fractures ; Fractures, Bone - epidemiology ; Fractures, Bone - etiology ; Fractures, Bone - prevention & control ; Humans ; Middle Aged ; Netherlands - epidemiology ; Osteoporosis ; Osteoporosis - complications ; Osteoporosis - drug therapy ; Osteoporosis - epidemiology ; Persistence ; Post-menopausal ; Risk Factors</subject><ispartof>Current medical research and opinion, 2006-09, Vol.22 (9), p.1757-1764</ispartof><rights>2006 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted 2006</rights><rights>Copyright Librapharm Sep 2006</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c427t-86184da5c037887b1edcf1c8b4b82b542cd081b7cc61bd8cb97a95e17e501b0d3</citedby><cites>FETCH-LOGICAL-c427t-86184da5c037887b1edcf1c8b4b82b542cd081b7cc61bd8cb97a95e17e501b0d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16968579$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van den Boogaard, C. H. A.</creatorcontrib><creatorcontrib>Breekveldt‐Postma, N. S.</creatorcontrib><creatorcontrib>Borggreve, S. E.</creatorcontrib><creatorcontrib>Goettsch, W. G.</creatorcontrib><creatorcontrib>Herings, R. M. C.</creatorcontrib><title>Persistent bisphosphonate use and the risk of osteoporotic fractures in clinical practice: a database analysis study</title><title>Current medical research and opinion</title><addtitle>Curr Med Res Opin</addtitle><description>ABSTRACT
Objective: This study aimed to investigate the association between persistent use of bisphosphonates and the risk of osteoporotic fractures in clinical practice.
Methods: Data were obtained from the PHARMO Record Linkage System, which includes, among other databases, drug-dispensing records from community pharmacies linked to hospital discharge records of more than two million subjects in defined areas in the Netherlands. Persistence with bisphosphonate therapy was assessed during a period of 3 years. A nested matched case control study (cases:controls = 1:10) was performed to study the association between persistent bisphosphonate use and hospitalisation for osteoporotic fractures and analysed by conditional logistic regression analysis. The analyses were adjusted for patient characteristics such as previous hospitalisations for fractures, co-morbidity and co-medication.
Results: 14 760 new female users of bisphosphonates were identified of which 541 women had a hospitalisation for osteoporotic fracture after start of bisphosphonate treatment (1–3 years follow-up). One-year persistence rates increased from 33% with alendronate daily to 48% with alendronate weekly, an increase of 15%. Similar results were obtained with risedronate daily and weekly. One year persistent use of bisphosphonates resulted in a statistical significant 26% lower fracture rate (OR 0.74; 95%CI 0.57–0.95) whereas 2 year persistent use resulted in a 32% lower rate (OR 0.68; 95%CI 0.47–0.96).
Conclusions: Persistent use of bisphosphonates decreases the risk of osteoporotic fractures in clinical practice. Approximately 6% of fractures among users of bisphosphonates could be prevented if persistence was improved by 20%. However, current persistence with bisphosphonate therapy is suboptimal and strategies that further increase persistence are likely to further prevent the number of fractures.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Bisphosphonates</subject><subject>Case-Control Studies</subject><subject>Diphosphonates - administration & dosage</subject><subject>Dosing regimen</subject><subject>Drug Administration Schedule</subject><subject>Female</subject><subject>Fractures</subject><subject>Fractures, Bone - epidemiology</subject><subject>Fractures, Bone - etiology</subject><subject>Fractures, Bone - prevention & control</subject><subject>Humans</subject><subject>Middle Aged</subject><subject>Netherlands - epidemiology</subject><subject>Osteoporosis</subject><subject>Osteoporosis - complications</subject><subject>Osteoporosis - drug therapy</subject><subject>Osteoporosis - epidemiology</subject><subject>Persistence</subject><subject>Post-menopausal</subject><subject>Risk Factors</subject><issn>0300-7995</issn><issn>1473-4877</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><recordid>eNp9kc9rFTEQx4Mo9rV69yTBg7fVZH8lW0-lWBUK7UHBW5gks7zUvM2aZJH33zfre1As2EMYyHy-3xm-Q8gbzj5wLruPrGFMDAPrf_KmbgR7Rja8FU3VSiGek83arkq_OyGnKd0xxms5DC_JCe-HXnZi2JB8izG5lHHKVLs0b8P6JshIl4QUJkvzFml06RcNIw2FDHOIITtDxwgmLxETdRM13k3OgKfz-usMnlOgFjJo-OsDfl_m0JQXu39FXozgE74-1jPy4-rz98uv1fXNl2-XF9eVaWuRK9lz2VroDGuElEJztGbkRupWy1p3bW0sk1wLY3qurTR6EDB0yAV2jGtmmzPy_uA7x_B7wZTVziWD3sOEYUmql7LthawL-O4ReBeWWHZOql4D7lg_FIgdIBNDShFHNUe3g7hXnKn1HOrxOYrk7dF30Tu0D4Jj_gX4dADcNIa4gz8heqsy7H2IJd7JuKSaJ-zP_1FvEXzeGoj4sP9_xfdg4ayC</recordid><startdate>200609</startdate><enddate>200609</enddate><creator>van den Boogaard, C. H. A.</creator><creator>Breekveldt‐Postma, N. S.</creator><creator>Borggreve, S. E.</creator><creator>Goettsch, W. G.</creator><creator>Herings, R. M. 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H. A. ; Breekveldt‐Postma, N. S. ; Borggreve, S. E. ; Goettsch, W. G. ; Herings, R. M. 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H. A.</au><au>Breekveldt‐Postma, N. S.</au><au>Borggreve, S. E.</au><au>Goettsch, W. G.</au><au>Herings, R. M. C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Persistent bisphosphonate use and the risk of osteoporotic fractures in clinical practice: a database analysis study</atitle><jtitle>Current medical research and opinion</jtitle><addtitle>Curr Med Res Opin</addtitle><date>2006-09</date><risdate>2006</risdate><volume>22</volume><issue>9</issue><spage>1757</spage><epage>1764</epage><pages>1757-1764</pages><issn>0300-7995</issn><eissn>1473-4877</eissn><coden>CMROCX</coden><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>ABSTRACT
Objective: This study aimed to investigate the association between persistent use of bisphosphonates and the risk of osteoporotic fractures in clinical practice.
Methods: Data were obtained from the PHARMO Record Linkage System, which includes, among other databases, drug-dispensing records from community pharmacies linked to hospital discharge records of more than two million subjects in defined areas in the Netherlands. Persistence with bisphosphonate therapy was assessed during a period of 3 years. A nested matched case control study (cases:controls = 1:10) was performed to study the association between persistent bisphosphonate use and hospitalisation for osteoporotic fractures and analysed by conditional logistic regression analysis. The analyses were adjusted for patient characteristics such as previous hospitalisations for fractures, co-morbidity and co-medication.
Results: 14 760 new female users of bisphosphonates were identified of which 541 women had a hospitalisation for osteoporotic fracture after start of bisphosphonate treatment (1–3 years follow-up). One-year persistence rates increased from 33% with alendronate daily to 48% with alendronate weekly, an increase of 15%. Similar results were obtained with risedronate daily and weekly. One year persistent use of bisphosphonates resulted in a statistical significant 26% lower fracture rate (OR 0.74; 95%CI 0.57–0.95) whereas 2 year persistent use resulted in a 32% lower rate (OR 0.68; 95%CI 0.47–0.96).
Conclusions: Persistent use of bisphosphonates decreases the risk of osteoporotic fractures in clinical practice. Approximately 6% of fractures among users of bisphosphonates could be prevented if persistence was improved by 20%. However, current persistence with bisphosphonate therapy is suboptimal and strategies that further increase persistence are likely to further prevent the number of fractures.</abstract><cop>England</cop><pub>Informa UK Ltd</pub><pmid>16968579</pmid><doi>10.1185/030079906X132370</doi><tpages>8</tpages></addata></record> |
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| ispartof | Current medical research and opinion, 2006-09, Vol.22 (9), p.1757-1764 |
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| language | eng |
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| source | Taylor and Francis:Jisc Collections:Taylor and Francis Read and Publish Agreement 2024-2025:Medical Collection (Reading list) |
| subjects | Aged Aged, 80 and over Bisphosphonates Case-Control Studies Diphosphonates - administration & dosage Dosing regimen Drug Administration Schedule Female Fractures Fractures, Bone - epidemiology Fractures, Bone - etiology Fractures, Bone - prevention & control Humans Middle Aged Netherlands - epidemiology Osteoporosis Osteoporosis - complications Osteoporosis - drug therapy Osteoporosis - epidemiology Persistence Post-menopausal Risk Factors |
| title | Persistent bisphosphonate use and the risk of osteoporotic fractures in clinical practice: a database analysis study |
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