Antiresorptive injections in older adult patients with prior osteoporotic fractures: a real-world observational study

IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Chun-Feng Huang, Shiue-Ming Lin, Jason C. Hsu, Russell O. Kosik, Wing P. Chan
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引用次数: 0

Abstract

Summary

Injectable antiresorptive drugs may reduce refracture risk in older adults with previous fractures, though further research is needed to explore related factors, including the crucial role of consistent adherence.

Purpose

Osteoporosis increases fracture risk, particularly in older adults. Spinal and hip fractures are common and costly complications. To examine the effectiveness of parenteral antiresorptive medications—denosumab and zoledronate—in reducing refracture rates among older adults with prior spinal or hip fractures.

Methods

A nationwide retrospective cohort study was conducted using data from Taiwan’s National Health Insurance Research Database (2011–2020). Patients aged 50 and older with spinal or hip fractures were divided into a treatment group (received zoledronate or denosumab) and a control group (no osteoporosis treatment). A 1:1 matching based on age, sex, and Charlson Comorbidity Index was performed. Kaplan–Meier method and Cox proportional hazards regression were used for analysis.

Results

Out of 23,331 eligible patients, 582 were in the treatment group and 17,281 in the control group. After matching, 211 patients received zoledronate and 367 received denosumab. The treatment group showed a trend toward lower refracture risk compared to the control group, though not statistically significant. Hazard ratios were 0.63 for zoledronate and 0.80 for denosumab, indicating potential benefits. There was no substantial difference between the two medications.

Conclusion

This is the first real-world study to assess the effectiveness of complete adherence to parenteral antiresorptive medications in reducing the risk of refractures among older adults with prior spinal or hip fractures. However, further research is needed to confirm these findings and investigate long-term effects.

Abstract Image

抗骨吸收注射治疗有骨质疏松性骨折的老年患者:一项真实世界的观察性研究
注射抗骨吸收药物可能会降低有过骨折史的老年人的再骨折风险,但需要进一步的研究来探索相关因素,包括持续依从性的关键作用。骨质疏松症增加骨折风险,尤其是老年人。脊柱和髋部骨折是常见且昂贵的并发症。研究肠外抗吸收药物-地诺单抗和唑来膦酸钠-在降低既往脊柱或髋部骨折的老年人再骨折率中的有效性。方法采用2011-2020年台湾全民健康保险研究数据库的数据,在全国范围内进行回顾性队列研究。50岁及以上脊柱或髋部骨折患者分为治疗组(接受唑来膦酸钠或地诺单抗治疗)和对照组(未接受骨质疏松治疗)。根据年龄、性别和Charlson合并症指数进行1:1匹配。采用Kaplan-Meier法和Cox比例风险回归进行分析。结果在23331例符合条件的患者中,治疗组582例,对照组17281例。配对后,211例患者接受唑来膦酸钠治疗,367例患者接受地诺单抗治疗。与对照组相比,治疗组显示出更低的再骨折风险趋势,但无统计学意义。唑来膦酸盐的风险比为0.63,地诺单抗的风险比为0.80,表明潜在的益处。两种药物之间没有实质性的差异。结论:这是第一个真实世界的研究,旨在评估完全坚持服用肠外抗吸收药物在降低既往脊柱或髋部骨折的老年人复发风险方面的有效性。然而,需要进一步的研究来证实这些发现并调查其长期影响。
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来源期刊
Archives of Osteoporosis
Archives of Osteoporosis ENDOCRINOLOGY & METABOLISMORTHOPEDICS -ORTHOPEDICS
CiteScore
5.50
自引率
10.00%
发文量
133
期刊介绍: Archives of Osteoporosis is an international multidisciplinary journal which is a joint initiative of the International Osteoporosis Foundation and the National Osteoporosis Foundation of the USA. The journal will highlight the specificities of different regions around the world concerning epidemiology, reference values for bone density and bone metabolism, as well as clinical aspects of osteoporosis and other bone diseases.
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