Comparisons Between Different Anti-osteoporosis Medications on Postfracture Mortality: A Population-Based Study

Wu, Chih‐Hsing; Li, Chia-Chun; Hsu, Yu-Hsuan; Liang, Fu-Wen; Chang, Yin-Fan; Hwang, Jawl‐Shan

doi:10.1210/clinem/dgac636

Cited by 14 publications

(4 citation statements)

References 29 publications

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“…The HORIZON (Health Outcomes and Reduced Incidence with Zoledronic Acid Once Yearly) Recurrent Fracture Trial originally demonstrated a 28% reduction in mortality in patients with a hip fracture who were randomized to receive zoledronic acid 14 . Current articles by Wu et al 15 and Tai et al 16 have evaluated the impact of various anti-osteoporotic drugs on all-cause mortality after hip fractures in a nationwide population study in Taiwan. In this large study, 45,266 patients with an osteoporotic hip fracture who were subsequently treated with various anti-osteoporotic drugs were identified.…”

Section: Osteoporosis Drug Therapymentioning

confidence: 99%

What’s New in Osteoporosis and Fragility Fractures

Lane

Witayakom

2023

Journal of Bone and Joint Surgery

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Update This article was updated on April 10, 2024, because of a previous error. On page 1304, the term “protein” that appeared incorrectly three times in the text that had read as “Their studies did reveal that metabolites from the protein pump inhibitor ingestion may directly and indirectly influence bone density through plasma metabolites involved in the sex hormone pathway. This article plus others have broadened the possible altered pathways related to protein pump inhibitor use. Regardless, these commonly used agents will compromise bone health. Clinicians should be alerted to this possibility when protein pump inhibitors are ingested.,” has now been replaced with the term “proton” so that the text now reads as “Their studies did reveal that metabolites from the proton pump inhibitor ingestion may directly and indirectly influence bone density through plasma metabolites involved in the sex hormone pathway. This article plus others have broadened the possible altered pathways related to proton pump inhibitor use. Regardless, these commonly used agents will compromise bone health. Clinicians should be alerted to this possibility when proton pump inhibitors are ingested.”

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Section: Osteoporosis Drug Therapymentioning

confidence: 99%

What’s New in Osteoporosis and Fragility Fractures

Lane

Witayakom

2023

Journal of Bone and Joint Surgery

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“…A number of studies (but not all [106]) concluded that use of antiresorptive medications improved survival [30,[107][108][109][110][111][112][113][114][115][116]. Our study does not have sufcient statistical power to reach the same conclusions.…”

Section: Ckd and Hospital Outcomesmentioning

confidence: 60%

Chronic Kidney Disease in Patients with Hip Fracture: Prevalence and Outcomes

Fisher,

Wang,

Smith

2024

International Journal of Clinical Practice

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Objective. Although the association between chronic kidney disease (CKD) and osteoporotic fractures is well established, data on CKD combined with hip fracture (HF) are scarce and controversial. We aimed to assess in patients with HF the prevalence of CKD, its impact on hospital mortality and length of stay (LOS) and to determine the prognostic value of CKD to predict hospital outcomes. Methods. Prospectively collected clinical data were analysed in 3623 consecutive HF patients aged ≥65 years (mean age 83.4 ± 7.50 [standard deviation] years; 74.4% females). Results. CKD among older patients with HF is highly prevalent (39.9%), has different clinical characteristics, a 2.5-fold higher mortality rate, and 40% greater risk of prolonged LOS. The strongest risk for a poor outcome was advanced age (>80 years). The risk of death substantially increases in combination with chronic disorders, especially coronary artery disease, anaemia, hyperparathyroidism, and atrial fibrillation; models based only on three variables—CKD stage, age >80, and presence of a specific chronic condition—predicted in-hospital death with good discrimination capability (AUC ≥ 0.700) and reasonable accuracy, the number needed to predict ranged between 5.7 and 14.5. Only 12% of HF patients received osteoporotic drugs prefracture. Conclusion. In HF patients with CKD, the risk of adverse outcomes largely increases in parallel with worsening kidney function and, especially, in combination with comorbidities; models based on three admission variables predict a fatal outcome. Assessment of renal function is essential to preventing osteoporotic fractures.

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“…Immediate strategies should also consider pharmacologic treatments to reduce imminent fracture risk. 31 , 32 , 34 Recently, a large population-based observational study has shown mortality benefits for various types of treatments 52 , 53 ; albeit, not without methodological limitations inherent to observational study design 54 and with adequately designed randomized trials examining all-cause mortality being scarce. 55 An absence of prior antiosteoporosis treatment was, however, observed to be associated with increased postfracture mortality, 12 and a clinical pathway focusing on improving post-fracture treatment rates, known as fracture liaison service, has also been shown to reduce mortality.…”

Section: Discussionmentioning

confidence: 99%

Postfracture survival in a population-based study of adults aged ≥66 yr: a call to action at hospital discharge

Vincent,

Adachi,

Schemitsch

et al. 2024

JBMR Plus

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Post-fracture survival rates provide prognostic information but are rarely reported along with other mortality outcomes in adults aged ≥50 years. The timing of survival change following a fracture also needs to be further elucidated. This population-based, matched-cohort, retrospective database study examined 98 474 patients (73% women) aged ≥66 years with an index fracture occurring at an osteoporotic site (hip, clinical vertebral, proximal non-hip non-vertebral [pNHNV], and distal non-hip non-vertebral [dNHNV]) from 2011 to 2015, who were matched (1:1) to non-fracture individuals based on sex, age, and comorbidities. All-cause 1- and 5-year overall survival and relative survival ratios (RSRs) were assessed and time trends in survival changes were characterized starting immediately after a fracture. In both sexes, overall survival was markedly decreased over 6 years of follow-up after hip, vertebral, and pNHNV fractures, and as expected, worse survival rates were observed in older patients and males. The lowest 5-year RSRs were observed after hip fractures in males (66–85 years, 51.9%–63.9%; ≥86 years, 34.5%), followed by vertebral fractures in males (66–85 years, 53.2%–69.4%; ≥86 years, 35.5%), and hip fractures in females (66–85 years, 69.8%–79.0%; ≥86 years, 52.8%). Although RSRs did not decrease as markedly after dNHNV fractures in younger patients, relatively low 5-year RSRs were observed in females (75.9%) and males (69.5%) aged ≥86 years. The greatest reduction in survival occurred within the initial month after hip, vertebral, and pNHNV fractures, indicating a high relative impact of short-term factors, with survival-reduction effects persisting over time. Therefore, the most critical period for implementing interventions aimed at improving post-fracture prognosis appears to be immediately after a fracture; however, considering the immediate need for introducing such interventions, primary fracture prevention is also crucial to prevent the occurrence of the initial fracture in high-risk patients.

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Comparisons Between Different Anti-osteoporosis Medications on Postfracture Mortality: A Population-Based Study

Cited by 14 publications

References 29 publications

What’s New in Osteoporosis and Fragility Fractures

What’s New in Osteoporosis and Fragility Fractures

Chronic Kidney Disease in Patients with Hip Fracture: Prevalence and Outcomes

Postfracture survival in a population-based study of adults aged ≥66 yr: a call to action at hospital discharge

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