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Fracture outcomes related to persistence and compliance with oral bisphosphonates.
J Bone Miner Res. 2008 Oct; 23(10):1569-75.JB

Abstract

The effects of low persistence on fracture risk have not been fully addressed. The objectives of this study were to describe the persistence and compliance with bisphosphonates and to evaluate the association with fracture risk. The General Practice Research database was used to identify patients >or=18 yr of age prescribed alendronate or risedronate. The follow-up was divided into periods of current and past use. Time-dependent Cox regression was used. The study population included 44,531 patients; 58.3% of the patients continued bisphosphonate treatment for >1 yr and 23.6% for >5 yr. The risk of hip/femur fracture (adjusted relative rate [RR], 0.78; 95% CI, 0.64-0.94) and osteoporotic fracture (RR, 0.85; 95% CI, 0.76-0.94) were lower with current compared with past bisphosphonate use. The largest reduction in hip/femur and osteoporotic fracture risk was observed in patients treated for at least 6 mo and no reduction in those treated for <6 mo. The risks of hip/femur and osteoporotic fractures followed the pattern of nonosteoporotic fractures in the first 6 mo but then started to reduce after 6-12 mo of treatment. Increased risks of osteoporotic and hip/femur fractures were found in patients with low compliance. Use of bisphosphonates was associated with fracture risk reductions after 6-12 mo of treatment, but only 58% of the patients were treated for at least 1 year. Improvement in long-term persistence to bisphosphonate treatment may be important to reduce the impact of osteoporosis-related fractures.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Gallagher AM
General Practice Research Database, Medicines and Healthcare Products Regulatory Agency, London, United Kingdom.
Rietbrock S
No affiliation info available
Olson M
No affiliation info available
van Staa TP
No affiliation info available

MeSH

Administration, OralAdolescentAdultAgedAged, 80 and overDiphosphonatesFemaleHip FracturesHumansMaleMiddle AgedOsteoporosisPatient ComplianceRisk Factors

Pub Type(s)

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

Language

eng

PubMed ID

18505366

Citation

Gallagher, Arlene M., et al. "Fracture Outcomes Related to Persistence and Compliance With Oral Bisphosphonates." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 23, no. 10, 2008, pp. 1569-75.
Gallagher AM, Rietbrock S, Olson M, et al. Fracture outcomes related to persistence and compliance with oral bisphosphonates. J Bone Miner Res. 2008;23(10):1569-75.
Gallagher, A. M., Rietbrock, S., Olson, M., & van Staa, T. P. (2008). Fracture outcomes related to persistence and compliance with oral bisphosphonates. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 23(10), 1569-75. https://doi.org/10.1359/jbmr.080510
Gallagher AM, et al. Fracture Outcomes Related to Persistence and Compliance With Oral Bisphosphonates. J Bone Miner Res. 2008;23(10):1569-75. PubMed PMID: 18505366.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fracture outcomes related to persistence and compliance with oral bisphosphonates. AU - Gallagher,Arlene M, AU - Rietbrock,Stephan, AU - Olson,Melvin, AU - van Staa,Tjeerd P, PY - 2008/5/29/pubmed PY - 2008/12/30/medline PY - 2008/5/29/entrez SP - 1569 EP - 75 JF - Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research JO - J Bone Miner Res VL - 23 IS - 10 N2 - The effects of low persistence on fracture risk have not been fully addressed. The objectives of this study were to describe the persistence and compliance with bisphosphonates and to evaluate the association with fracture risk. The General Practice Research database was used to identify patients >or=18 yr of age prescribed alendronate or risedronate. The follow-up was divided into periods of current and past use. Time-dependent Cox regression was used. The study population included 44,531 patients; 58.3% of the patients continued bisphosphonate treatment for >1 yr and 23.6% for >5 yr. The risk of hip/femur fracture (adjusted relative rate [RR], 0.78; 95% CI, 0.64-0.94) and osteoporotic fracture (RR, 0.85; 95% CI, 0.76-0.94) were lower with current compared with past bisphosphonate use. The largest reduction in hip/femur and osteoporotic fracture risk was observed in patients treated for at least 6 mo and no reduction in those treated for <6 mo. The risks of hip/femur and osteoporotic fractures followed the pattern of nonosteoporotic fractures in the first 6 mo but then started to reduce after 6-12 mo of treatment. Increased risks of osteoporotic and hip/femur fractures were found in patients with low compliance. Use of bisphosphonates was associated with fracture risk reductions after 6-12 mo of treatment, but only 58% of the patients were treated for at least 1 year. Improvement in long-term persistence to bisphosphonate treatment may be important to reduce the impact of osteoporosis-related fractures. SN - 1523-4681 UR - https://www.unboundmedicine.com/medline/citation/18505366/Fracture_outcomes_related_to_persistence_and_compliance_with_oral_bisphosphonates_ L2 - https://doi.org/10.1359/jbmr.080510 DB - PRIME DP - Unbound Medicine ER -