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Osteoporosis International

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07.01.2021 | Original Article

Fracture rates in patients discontinuing alendronate treatment in real life: a population-based cohort study

verfasst von: A.S. Sølling, D.H. Christensen, B. Darvalics, T. Harsløf, R.W. Thomsen, B. Langdahl

Erschienen in: Osteoporosis International | Ausgabe 6/2021

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Abstract

Summary

In this nationwide register-based cohort study, we found no difference in the risk of fractures in patients discontinuing versus continuing alendronate (ALN) treatment after 5 years.

Introduction

Information on fracture risk in patients discontinuing ALN in a real-life setting is sparse. We aimed to examine ALN discontinuation patterns, compare fracture rates in patients discontinuing versus continuing ALN after 5 years of treatment, and define determinants of fractures in ALN discontinuers.

Methods

A nationwide population-based cohort study using Danish health registry data. Our source population was individuals who had redeemed ≥ 2 ALN prescriptions between January 1, 1995, and September 1, 2017.

Results

We found that 25% of all ALN initiators used ALN for less than 1 year and 43% continued treatment for at least 5 years. We classified n = 1865 as ALN discontinuers and n = 29,619 as ALN continuers. Using Cox proportional hazards regression analysis and an “as-treated” approach, we observed no increased risk of any fracture (incidence rate ratio (IRR) 1.06, 95% CI 0.92–1.23), vertebral fracture (IRR 0.59, 95% CI 0.33–1.05), hip fracture (IRR 1.04, 95% CI 0.75–1.45), or major osteoporotic fracture (IRR 1.05, 95% CI 0.88–1.25) in the ALN discontinuers compared to continuers during a follow-up time of 1.84 ± 1.56 years (mean ± SD) and 2.51 ± 1.60 years, respectively. ALN re-initiation was a major determinant of follow-up among the discontinuers. Old age (> 80 vs. 50–60 years, unadjusted IRR 2.92, 95% CI 1.18–7.24) was the strongest determinant for fractures following ALN discontinuation.

Conclusion

In a real-world setting, less than 50% continued ALN treatment for 5 years. We found no difference in the risk of fractures in patients discontinuing versus continuing ALN after 5 years.

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Titel: Fracture rates in patients discontinuing alendronate treatment in real life: a population-based cohort study
verfasst von: A.S. Sølling
D.H. Christensen
B. Darvalics
T. Harsløf
R.W. Thomsen
B. Langdahl
Publikationsdatum: 07.01.2021
Verlag: Springer London
Erschienen in: Osteoporosis International / Ausgabe 6/2021
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-020-05745-x

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Springer Medizin

Fracture rates in patients discontinuing alendronate treatment in real life: a population-based cohort study

Abstract

Summary

Introduction

Methods

Results

Conclusion

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Abstract

Summary

Introduction

Methods

Results

Conclusion

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