Use of antiosteoporotic drugs and calcium/vitamin D in patients with fragility fractures: impact on re-fracture and mortality risk

Purpose To evaluate the impact of pharmacological treatment in osteoporosis patients with recent fracture and to assess the incidence of subsequent fracture and all-cause mortality. Methods This observational retrospective study was based on data from administrative databases of five Italian Local H...

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Bibliographic Details
Published in:Endocrine 2019-05, Vol.64 (2), p.367-377
Main Authors: Degli Esposti, Luca, Girardi, Anna, Saragoni, Stefania, Sella, Stefania, Andretta, Margherita, Rossini, Maurizio, Giannini, Sandro
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Bone Density Conservation Agents - adverse effects
Bone Density Conservation Agents - therapeutic use
Calcium
Calcium - therapeutic use
Diabetes
Drug therapy
Endocrinology
Female
Fractures
Health risk assessment
Hip
Humanities and Social Sciences
Humans
Internal Medicine
Male
Medication Adherence
Medicine
Medicine & Public Health
Middle Aged
Mortality
multidisciplinary
Original Article
Osteoporosis
Osteoporosis - drug therapy
Osteoporotic Fractures - epidemiology
Osteoporotic Fractures - mortality
Osteoporotic Fractures - prevention & control
Recurrence
Retrospective Studies
Risk
Science
Secondary Prevention
Supplements
Vertebrae
Vitamin D
Vitamin D - therapeutic use
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Summary:Purpose To evaluate the impact of pharmacological treatment in osteoporosis patients with recent fracture and to assess the incidence of subsequent fracture and all-cause mortality. Methods This observational retrospective study was based on data from administrative databases of five Italian Local Health Units. Osteoporosis patients aged ≥ 50 years with hospitalization for vertebral or hip fracture occurring between 01/01/2011 and 31/12/2015 were included. Treatment adherence was calculated using the medication possession ratio. Multivariable proportional hazard Cox model was used to identify factors associated with time to re-fracture and all-cause mortality. Results A cohort of 3475 patients were included and 41.5% of them did not receive any specific anti-fracture treatment. Among treated patients ( N  = 2032), the majority (83.6%) received calcium/vitamin D supplementation. Over a mean follow-up of 3 years, the risk of subsequent fractures was 44.4% lower in treated patients compared to untreated ones (HR = 0.556, 95% CI = 0.420–0.735, p  
ISSN:1355-008X
1559-0100
DOI:10.1007/s12020-018-1824-9