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Population-based study of the effectiveness of bone-specific drugs in reducing the risk of osteoporotic fracture.
Pharmacoepidemiol Drug Saf. 2008 Mar; 17(3):248-59.PD

Abstract

AIM

Evidence supports bone-specific drugs (BSDs) efficacy in the fracture risk reduction. But treatment rates for osteoporosis among high-risk patients are far below the recommended guidelines. A major concern about BSDs is the lack of adherence with treatment.

OBJECTIVE

To determine if BSDs decrease fracture risk in high-risk elderly women in real clinical setting.

METHODS

A nested case-control design was used in a cohort of elderly women from the Quebec health databases. Women enter into the cohort if they are 70 years or older between 1995 and 2003. Nested case-controls were designed for women with a diagnosis of osteoporosis (OP) and for those with a prior fracture. All cases of fractures occurring during follow-up were matched with 10 randomly selected controls based on age, time period, bone mass density testing, and having a diagnosis of OP or a prior fracture. Use of BSDs before the index date was categorized as follows: short-term (< or =1 year), intermediate-term (>1 and < or = 3 years), and long-term (>3 years). We used an adjusted conditional logistic regression model to assess BSD effect on fracture.

RESULTS

Among 3170 women who had a fracture, of these women, 1824 had OP and 1346 had a prior fracture. Only long-term exposure to BSDs among women with OP reduced the fracture risk by 16% (odds ratio: 0.84; 0.73-0.97). Among women with OP, a high number of medical services or use of anticonvulsants or narcotics increased the fracture risk by 12-73%. Among women with a prior fracture, a high number of medical services or risk of fall or use of benzodiazepines, antidepressants, or narcotics increased the fracture risk by 23-77%.

CONCLUSION

The incidence of fractures decreased by 16% among women with OP when more than 80% of BSDs was used for at least 3 years. Among women with a prior fracture, fracture risk reduction was not significant. Exposure to BSDs among women with a prior fracture is troubling, given that only approximately 12% of these individuals were being treated, and only 2% was using BSDs for the long term.

Authors+Show Affiliations

Faculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada. sylvie.perreault@umontreal.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18213734

Citation

Perreault, Sylvie, et al. "Population-based Study of the Effectiveness of Bone-specific Drugs in Reducing the Risk of Osteoporotic Fracture." Pharmacoepidemiology and Drug Safety, vol. 17, no. 3, 2008, pp. 248-59.
Perreault S, Dragomir A, Blais L, et al. Population-based study of the effectiveness of bone-specific drugs in reducing the risk of osteoporotic fracture. Pharmacoepidemiol Drug Saf. 2008;17(3):248-59.
Perreault, S., Dragomir, A., Blais, L., Moride, Y., Rossignol, M., Ste-Marie, L. G., & Fernandès, J. C. (2008). Population-based study of the effectiveness of bone-specific drugs in reducing the risk of osteoporotic fracture. Pharmacoepidemiology and Drug Safety, 17(3), 248-59. https://doi.org/10.1002/pds.1551
Perreault S, et al. Population-based Study of the Effectiveness of Bone-specific Drugs in Reducing the Risk of Osteoporotic Fracture. Pharmacoepidemiol Drug Saf. 2008;17(3):248-59. PubMed PMID: 18213734.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Population-based study of the effectiveness of bone-specific drugs in reducing the risk of osteoporotic fracture. AU - Perreault,Sylvie, AU - Dragomir,Alice, AU - Blais,Lucie, AU - Moride,Yola, AU - Rossignol,Michel, AU - Ste-Marie,Louis-Georges, AU - Fernandès,Julio Cesar, PY - 2008/1/24/pubmed PY - 2008/4/11/medline PY - 2008/1/24/entrez SP - 248 EP - 59 JF - Pharmacoepidemiology and drug safety JO - Pharmacoepidemiol Drug Saf VL - 17 IS - 3 N2 - AIM: Evidence supports bone-specific drugs (BSDs) efficacy in the fracture risk reduction. But treatment rates for osteoporosis among high-risk patients are far below the recommended guidelines. A major concern about BSDs is the lack of adherence with treatment. OBJECTIVE: To determine if BSDs decrease fracture risk in high-risk elderly women in real clinical setting. METHODS: A nested case-control design was used in a cohort of elderly women from the Quebec health databases. Women enter into the cohort if they are 70 years or older between 1995 and 2003. Nested case-controls were designed for women with a diagnosis of osteoporosis (OP) and for those with a prior fracture. All cases of fractures occurring during follow-up were matched with 10 randomly selected controls based on age, time period, bone mass density testing, and having a diagnosis of OP or a prior fracture. Use of BSDs before the index date was categorized as follows: short-term (< or =1 year), intermediate-term (>1 and < or = 3 years), and long-term (>3 years). We used an adjusted conditional logistic regression model to assess BSD effect on fracture. RESULTS: Among 3170 women who had a fracture, of these women, 1824 had OP and 1346 had a prior fracture. Only long-term exposure to BSDs among women with OP reduced the fracture risk by 16% (odds ratio: 0.84; 0.73-0.97). Among women with OP, a high number of medical services or use of anticonvulsants or narcotics increased the fracture risk by 12-73%. Among women with a prior fracture, a high number of medical services or risk of fall or use of benzodiazepines, antidepressants, or narcotics increased the fracture risk by 23-77%. CONCLUSION: The incidence of fractures decreased by 16% among women with OP when more than 80% of BSDs was used for at least 3 years. Among women with a prior fracture, fracture risk reduction was not significant. Exposure to BSDs among women with a prior fracture is troubling, given that only approximately 12% of these individuals were being treated, and only 2% was using BSDs for the long term. SN - 1099-1557 UR - https://www.unboundmedicine.com/medline/citation/18213734/Population_based_study_of_the_effectiveness_of_bone_specific_drugs_in_reducing_the_risk_of_osteoporotic_fracture_ L2 - https://doi.org/10.1002/pds.1551 DB - PRIME DP - Unbound Medicine ER -