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Antiresorptives Cut Recurrent Hip Fractures


 

PHILADELPHIA — Antiresorptive therapy reduces the risk of recurrent hip fracture by more than 25%, according to one analysis presented at the annual meeting of the American Society for Bone and Mineral Research.

Patients who were exposed to bisphosphonate therapy following a first hip fracture had a 26% reduction in recurrent hip fracture (hazard ratio [HR] 0.74), after adjusting for age, sex, comorbidity, and medication, Dr. Suzanne N. Morin, an internist at the McGill University Health Centre in Montreal said at the meeting.

Dr. Morin and her colleagues performed a retrospective cohort study, using administrative databases to identify patients who were aged 65 years and older and who had been hospitalized for a first hip fracture between 1996 and 2003.

A total of 20,644 patients were identified and classified based on whether they had been exposed to antiresorptive therapy following hospital discharge after treatment of hip fracture, Dr. Morin said.

Exposure was defined as being dispensed a prescription for bisphosphonates, raloxifene, calcitonin, or hormone replacement therapy.

Of the 20,644 patients, 6,779 were exposed to antiresorptive therapy (mean time to first exposure after hospital discharge was 3 months) and 13,865 were not exposed.

Most of the patients—90% of those exposed and 73% of those not exposed—were women.

“In general, the exposed patients tended to be younger and to have fewer comorbidities than the nonexposed,” Dr. Morin said.

The patients who had been exposed to antiresorptives were also more likely to take calcium and vitamin D supplements and to use corticosteroids.

Bisphosphonates were prescribed the most frequently.

For exposed patients, follow-up began on the day that the prescription for an antiresorptive was filled.

Patients who had not been exposed to antiresorptives were assigned starting dates that were frequency matched to those of the exposed patients.

Mean follow-up was 2.2 years, during which time 9,146 patients died and 992 recurrent fractures occurred.

The refracture rate was 2.17 per 100 person-years for the exposed group and 2.9 per 100 person-years for the nonexposed group.

Men in the study were also less likely to have a recurrent hip fracture (HR 0.75). For each 1-year increase in age, the risk of recurrent hip fracture increased by 3%, Dr. Morin said. The presence of osteoporosis was associated with a twofold increase in the risk of recurrent hip fracture.

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