Takeaway
- Current oral bisphosphonates (BPs) use was associated with higher mortality risk after non-hip major osteoporotic fracture (MOF) and lower mortality risk after hip fracture.
- The risk for mortality was reduced in patients with non-hip MOF and hip fracture with 1 and 5 years of follow-up and risk reduction was greater within the first year.
Why this matters
- Future studies should evaluate the association between BPs use and mortality risk after fracture to explain alternative mechanisms of potential pleiotropic effects of BPs and potential unmeasured distortion.
Study design
- Population-based cohort study included 163,273 patients with an MOF (aged ≥50 years) using the UK Clinical Practice Research Datalink (CPRD).
- Risk of all-cause mortality was compared between current (0-6 months), recent (7-12 months) and past (>1 year) BPs use after non-hip MOF and hip fracture.
- Funding: None.
Key results
- Of 163,273 patients, 119,107 (72.9%) had non-hip MOF and 44,166 (27.1%) had hip fractures.
- Current BP use vs no use was associated with higher all-cause mortality risk in non-hip MOF (adjusted HR [aHR], 1.07; 95% CI, 1.03-1.10) and lower all-cause mortality risk in hip fracture group (aHR, 0.72; 95% CI, 0.70-0.75).
- Past BP use vs no use was associated with lower risk for all-cause mortality in non-hip MOF (aHR, 0.86; 95% CI, 0.83-0.90) and hip fracture (aHR, 0.58; 95% CI, 0.55-0.62) group.
- During 5-year analysis, current BP use vs no use was linked to lower mortality risk after non-hip MOF (aHR, 0.91; 95% CI, 0.87-0.95) and hip fracture (aHR, 0.61; 95% CI, 0.59-0.64).
- During the 1-year analysis, risk reduction was greater in non-hip MOF (aHR, 0.66; 95% CI, 0.60-0.72) and hip fracture (aHR, 0.41; 95% CI, 0.37-0.44) group with current BP use.
- Women vs men were at lower risk for all-cause mortality.
Limitations
- Study did not exclude participants who died shortly after having a fracture.
References
References
