Risk factors for fracture among current, persistent users of bisphosphonates

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

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

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.

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.

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.

Conclusion: Persistent, current bisphosphonate users remain at risk of fracture, and additional measures to prevent fractures in these patients would be of benefit.

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.

Original languageEnglish (US)
Pages (from-to)713-725
Number of pages13
JournalOsteoporosis International
Volume26
Issue number2
DOIs
StatePublished - Feb 2014

Keywords

  • Bisphosphonates
  • Fractures
  • Osteoporosis
  • Risk factors

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

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