Osteoporosis: alendronate, risedronate yield survival benefit in 15-year study

  • Bliuc D & al.
  • Osteoporos Int
  • 3 Jan 2019

  • curated by Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • A large, 15-year observational cohort study finds that nitrogen-bisphosphonates (alendronate and risedronate) used for osteoporosis are associated with a 34% reduction in mortality risk relative to no treatment.
  • The nitrogen-bisphosphonates (n-BP) have a 53% reduction in mortality risk relative to the non-nitrogen-bisphosphonate (non-n-BP) etidronate.

Why this matters

  • Findings support greater reliance on n-BP for treating osteoporosis.

Study design

  • Population-based prospective cohort (n=6120) of adults ≥50 years participating in the Canadian Multicentre Osteoporosis Study (1995-2013).
  • All-cause mortality between users of n-BP and non-n-BP was compared directly, and each user group was compared with untreated (nonusers) control patients who were propensity matched (by age, sex, comorbidities, fragility fracture status, among other factors).
  • Funding: Canadian Institutes of Health Research; MSD; Eli Lilly; Novartis; others.

Key results

  • n-BP use (vs nonuse) was associated with 34% reduced mortality risk (HR, 0.66; 95% CI, 0.48-0.91), but non-n-BP (vs nonuse) was not (HR, 0.89; 95% CI, 0.66-1.20).
    • n-BP use by women had the greatest risk reduction (HR, 0.58; 95% CI, 0.39-0.84).
  • n-BP vs non-n-BP use was associated with 53% reduced mortality risk (HR, 0.47; 95% CI, 0.31-0.70) in a direct comparison (n=340 pairs).

Limitations

  • Observational design.
  • No data on dosage.
  • Potential unmeasured confounders.