Secular Trends in Long-Term Oral Bisphosphonate Use

Juergens, Nathan; Ettinger, Bruce; Hui, Rita L.; Chandra, Malini; Lo, Joan C.

doi:10.1007/s11606-019-04934-7

Cited by 2 publications

(2 citation statements)

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“…Our findings suggest that among long-term BP users, several expected factors appear to influence treatment continuation, specifically low BMD, recent fracture, and era of treatment initiation. Our data indicate an interesting secular trend in BP continuation, also reported elsewhere 21 -since 2008, BP use beyond the initial 5 years of treatment was less common than in the previous years.…”

Section: ■■ Conclusionsupporting

confidence: 86%

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Determinants of Oral Bisphosphonate Use Beyond 5 Years

Izano

Ettinger

et al. 2020

JMCP

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BACKGROUND: Few studies have examined factors that determine bisphosphonate (BP) continuation beyond 5 years in clinical practice. OBJECTIVE: To investigate factors associated with BP continuation among women who completed 5 years of BP therapy. METHODS: Women who received 5 consecutive years of oral BP treatment entered the cohort during 2002-2014 and were followed up to 5 additional years. Multivariable logistic regression was used to evaluate the association of demographic and clinical factors with adherent treatment continuation. RESULTS: The cohort included 19,091 women with a median age of 72 years. Baseline and time-varying factors associated with increased odds of BP continuation after 5 years were (a) most recent bone mineral density (BMD) T-score-2 to-2.4 (OR = 1.31, 95% CI = 1.25-1.38), T-score-2.5 to-2.9 (OR = 1.48, 95% CI = 1.39-1.57), and T-score ≤-3.0 (OR = 1.57, 95% CI = 1.47-1.68) versus T-scores above-2.0; (b) index date before 2008 (OR =1.35, 95% CI = 1.29-1.41); and (c) diabetes mellitus (OR = 1.08, 95% CI = 1.01-1.16). In contrast, factors associated with decreased odds of BP continuation were (a) recent hip (OR = 0.61, 95% CI = 0.52-0.71) or humerus (OR = 0.79, 95% CI = 0.66-0.94) fracture or fracture other than hip, wrist, spine, or humerus (OR = 0.90, 95% CI = 0.84-0.97); (b) Charlson Comorbidity Index score > 2 (OR = 0.91, 95% CI = 0.84-0.98); (c) history of rheumatoid arthritis (OR = 0.89, 95% CI = 0.80-0.99); (d) Hispanic (OR = 0.89, 95% CI=0.85-0.94) or Asian (OR = 0.90, 95% CI = 0.85-0.94) race/ethnicity; and (e) use of proton pump inhibitors (OR = 0.65, 95% CI = 0.59-0.71). Patient age and fracture before BP initiation were not associated with treatment continuation. CONCLUSIONS: Clinical factors predicting continued BP treatment beyond 5 years include low BMD T-score, absence of recent fracture, and earlier era of treatment. Use of proton pump inhibitors was associated with lower likelihood of BP continuation. Other clinical and demographic factors were also noted to have variable effects on BP treatment continuation.

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Section: ■■ Conclusionsupporting

confidence: 86%

“…The current study confirms our previous finding reported from a northern California cohort of women receiving long-term BP therapy, where a decline in continuation of longterm therapy (up to 3 and 5 years) was also evident in later compared with earlier treatment eras. 21…”

Section: ■■ Discussionmentioning

confidence: 99%