Timing of Bisphosphonate (Alendronate) Initiation after Surgery for Fragility Fracture: A Population-Based Cohort Study
Bisphosphonates are used as first-line treatment for the prevention of fragility fracture (FF); they act by inhibiting osteoclast-mediated bone resorption. The timing of their administration after FF surgery is controversial; thus, we compared the incidence of second FF, surgery for second FF, and a...
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MDPI AG
2021-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/12/2541 |
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| author | Meng-Huang Wu Yu-Sheng Lin Christopher Wu Ching-Yu Lee Yi-Chia Chen Tsung-Jen Huang Jur-Shan Cheng |
| author_facet | Meng-Huang Wu Yu-Sheng Lin Christopher Wu Ching-Yu Lee Yi-Chia Chen Tsung-Jen Huang Jur-Shan Cheng |
| author_sort | Meng-Huang Wu |
| collection | DOAJ |
| description | Bisphosphonates are used as first-line treatment for the prevention of fragility fracture (FF); they act by inhibiting osteoclast-mediated bone resorption. The timing of their administration after FF surgery is controversial; thus, we compared the incidence of second FF, surgery for second FF, and adverse events associated with early initiation of bisphosphonates (EIBP, within 3 months of FF surgery) and late initiation of bisphosphonates (LIBP, 3 months after FF surgery) in bisphosphonate-naïve patients. This retrospective population-based cohort study used data from Taiwan’s Health and Welfare Data Science Center (2004–2012). A total of 298,377 patients received surgeries for FF between 2006 and 2010; of them, 1209 (937 EIBP and 272 LIBP) received first-time bisphosphonates (oral alendronate, 70 mg, once a week). The incidence of second FF (subdistribution hazard ratio (SHR) = 0.509; 95% confidence interval (CI): 0.352–0.735), second FF surgery (SHR = 0.452; 95% CI: 0.268–0.763), and adverse events (SHR = 0.728; 95% CI: 0.594–0.893) was significantly lower in the EIBP group than in the LIBP group. Our findings indicate that bisphosphonates should be initiated within 3 months after surgery for FF. |
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| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T10:37:12Z |
| publishDate | 2021-06-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-7b133160f6f4483aa597b7421fdbb9772023-11-21T23:15:19ZengMDPI AGJournal of Clinical Medicine2077-03832021-06-011012254110.3390/jcm10122541Timing of Bisphosphonate (Alendronate) Initiation after Surgery for Fragility Fracture: A Population-Based Cohort StudyMeng-Huang Wu0Yu-Sheng Lin1Christopher Wu2Ching-Yu Lee3Yi-Chia Chen4Tsung-Jen Huang5Jur-Shan Cheng6Department of Orthopedics, Taipei Medical University Hospital, Taipei 110301, TaiwanDepartment of Cardiology, Chang Gung Memorial Hospital, Chiayi 613016, TaiwanCollege of Medicine, Taipei Medical University, Taipei 110301, TaiwanDepartment of Orthopedics, Taipei Medical University Hospital, Taipei 110301, TaiwanResearch Services Center for Health Information, Chang Gung University, Taoyuan 333323, TaiwanDepartment of Orthopedics, Taipei Medical University Hospital, Taipei 110301, TaiwanClinical Informatics and Medical Statistics Research Center, College of Medicine, Chang Gung University, Taoyuan 333323, TaiwanBisphosphonates are used as first-line treatment for the prevention of fragility fracture (FF); they act by inhibiting osteoclast-mediated bone resorption. The timing of their administration after FF surgery is controversial; thus, we compared the incidence of second FF, surgery for second FF, and adverse events associated with early initiation of bisphosphonates (EIBP, within 3 months of FF surgery) and late initiation of bisphosphonates (LIBP, 3 months after FF surgery) in bisphosphonate-naïve patients. This retrospective population-based cohort study used data from Taiwan’s Health and Welfare Data Science Center (2004–2012). A total of 298,377 patients received surgeries for FF between 2006 and 2010; of them, 1209 (937 EIBP and 272 LIBP) received first-time bisphosphonates (oral alendronate, 70 mg, once a week). The incidence of second FF (subdistribution hazard ratio (SHR) = 0.509; 95% confidence interval (CI): 0.352–0.735), second FF surgery (SHR = 0.452; 95% CI: 0.268–0.763), and adverse events (SHR = 0.728; 95% CI: 0.594–0.893) was significantly lower in the EIBP group than in the LIBP group. Our findings indicate that bisphosphonates should be initiated within 3 months after surgery for FF.https://www.mdpi.com/2077-0383/10/12/2541fragility fractureinitiation timingsecond fractureadverse events |
| spellingShingle | Meng-Huang Wu Yu-Sheng Lin Christopher Wu Ching-Yu Lee Yi-Chia Chen Tsung-Jen Huang Jur-Shan Cheng Timing of Bisphosphonate (Alendronate) Initiation after Surgery for Fragility Fracture: A Population-Based Cohort Study Journal of Clinical Medicine fragility fracture initiation timing second fracture adverse events |
| title | Timing of Bisphosphonate (Alendronate) Initiation after Surgery for Fragility Fracture: A Population-Based Cohort Study |
| title_full | Timing of Bisphosphonate (Alendronate) Initiation after Surgery for Fragility Fracture: A Population-Based Cohort Study |
| title_fullStr | Timing of Bisphosphonate (Alendronate) Initiation after Surgery for Fragility Fracture: A Population-Based Cohort Study |
| title_full_unstemmed | Timing of Bisphosphonate (Alendronate) Initiation after Surgery for Fragility Fracture: A Population-Based Cohort Study |
| title_short | Timing of Bisphosphonate (Alendronate) Initiation after Surgery for Fragility Fracture: A Population-Based Cohort Study |
| title_sort | timing of bisphosphonate alendronate initiation after surgery for fragility fracture a population based cohort study |
| topic | fragility fracture initiation timing second fracture adverse events |
| url | https://www.mdpi.com/2077-0383/10/12/2541 |
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