Refracture risk and all-cause mortality after vertebral fragility fractures: Anti-osteoporotic medications matter
Background: Osteoporotic vertebral fractures may predict the future occurrence of fractures and increase mortality. Treating underlying osteoporosis may prevent second fractures. However, whether anti-osteoporotic treatment can reduce the mortality rate is not clear. The aim of this population study...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Journal of the Formosan Medical Association |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664623001122 |
| _version_ | 1797665416541110272 |
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| author | Ta-Wei Tai Yi-Lun Tsai Chien-An Shih Chia-Chun Li Yin-Fan Chang Chun-Feng Huang Tien-Tsai Cheng Jawl-Shan Hwang Tsung-Hsueh Lu Chih-Hsing Wu |
| author_facet | Ta-Wei Tai Yi-Lun Tsai Chien-An Shih Chia-Chun Li Yin-Fan Chang Chun-Feng Huang Tien-Tsai Cheng Jawl-Shan Hwang Tsung-Hsueh Lu Chih-Hsing Wu |
| author_sort | Ta-Wei Tai |
| collection | DOAJ |
| description | Background: Osteoporotic vertebral fractures may predict the future occurrence of fractures and increase mortality. Treating underlying osteoporosis may prevent second fractures. However, whether anti-osteoporotic treatment can reduce the mortality rate is not clear. The aim of this population study was to identify the degree of decreased mortality following the use of anti-osteoporotic medication after vertebral fractures. Methods: We identified patients who had newly diagnosed osteoporosis and vertebral fractures from 2009 to 2019 using the Taiwan National Health Insurance Research Database (NHIRD). We used national death registration data to determine the overall mortality rate. Results: There were 59,926 patients with osteoporotic vertebral fractures included in this study. After excluding patients with short-term mortality, patients who had previously received anti-osteoporotic medications had a lower refracture rate as well as a lower mortality risk (hazard ratio (HR): 0.84, 95% confidence interval (CI): 0.81–0.88). Patients receiving treatment for more than 3 years had a much lower mortality risk (HR: 0.53, 95% CI: 0.50–0.57). Patients who used oral bisphosphonates (alendronate and risedronate, HR: 0.95, 95% CI: 0.90–1.00), intravenous zoledronic acid (HR: 0.83, 95% CI: 0.74–0.93), and subcutaneous denosumab injections (HR: 0.71, 95% CI: 0.65–0.77) had lower mortality rates than patients without further treatment after vertebral fractures. Conclusion: In addition to fracture prevention, anti-osteoporotic treatments for patients with vertebral fractures were associated with a reduction in mortality. A longer duration of treatment and the use of long-acting drugs was also associated with lower mortality. |
| first_indexed | 2024-03-11T19:43:37Z |
| format | Article |
| id | doaj.art-895f0f7894984e54afce3baef172a296 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-03-11T19:43:37Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-895f0f7894984e54afce3baef172a2962023-10-06T04:43:52ZengElsevierJournal of the Formosan Medical Association0929-66462023-01-01122S65S73Refracture risk and all-cause mortality after vertebral fragility fractures: Anti-osteoporotic medications matterTa-Wei Tai0Yi-Lun Tsai1Chien-An Shih2Chia-Chun Li3Yin-Fan Chang4Chun-Feng Huang5Tien-Tsai Cheng6Jawl-Shan Hwang7Tsung-Hsueh Lu8Chih-Hsing Wu9Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Skeleton Materials and Biocompatibility Core Lab, Research Center of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanDepartment of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanDepartment of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanInstitute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanDepartment of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanDivision of Family Medicine, En Chu Kong Hospital, New Taipei City, Taiwan; Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Leisure Services Management, Chaoyang University of Technology, Taichung, TaiwanDivision of Rheumatology, Allergy, and Immunology, Chang Gung University and Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, TaiwanDivision of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, TaiwanDepartment of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Corresponding author.Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Corresponding author. Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.Background: Osteoporotic vertebral fractures may predict the future occurrence of fractures and increase mortality. Treating underlying osteoporosis may prevent second fractures. However, whether anti-osteoporotic treatment can reduce the mortality rate is not clear. The aim of this population study was to identify the degree of decreased mortality following the use of anti-osteoporotic medication after vertebral fractures. Methods: We identified patients who had newly diagnosed osteoporosis and vertebral fractures from 2009 to 2019 using the Taiwan National Health Insurance Research Database (NHIRD). We used national death registration data to determine the overall mortality rate. Results: There were 59,926 patients with osteoporotic vertebral fractures included in this study. After excluding patients with short-term mortality, patients who had previously received anti-osteoporotic medications had a lower refracture rate as well as a lower mortality risk (hazard ratio (HR): 0.84, 95% confidence interval (CI): 0.81–0.88). Patients receiving treatment for more than 3 years had a much lower mortality risk (HR: 0.53, 95% CI: 0.50–0.57). Patients who used oral bisphosphonates (alendronate and risedronate, HR: 0.95, 95% CI: 0.90–1.00), intravenous zoledronic acid (HR: 0.83, 95% CI: 0.74–0.93), and subcutaneous denosumab injections (HR: 0.71, 95% CI: 0.65–0.77) had lower mortality rates than patients without further treatment after vertebral fractures. Conclusion: In addition to fracture prevention, anti-osteoporotic treatments for patients with vertebral fractures were associated with a reduction in mortality. A longer duration of treatment and the use of long-acting drugs was also associated with lower mortality.http://www.sciencedirect.com/science/article/pii/S0929664623001122Vertebral fractureOsteoporosisMortality |
| spellingShingle | Ta-Wei Tai Yi-Lun Tsai Chien-An Shih Chia-Chun Li Yin-Fan Chang Chun-Feng Huang Tien-Tsai Cheng Jawl-Shan Hwang Tsung-Hsueh Lu Chih-Hsing Wu Refracture risk and all-cause mortality after vertebral fragility fractures: Anti-osteoporotic medications matter Journal of the Formosan Medical Association Vertebral fracture Osteoporosis Mortality |
| title | Refracture risk and all-cause mortality after vertebral fragility fractures: Anti-osteoporotic medications matter |
| title_full | Refracture risk and all-cause mortality after vertebral fragility fractures: Anti-osteoporotic medications matter |
| title_fullStr | Refracture risk and all-cause mortality after vertebral fragility fractures: Anti-osteoporotic medications matter |
| title_full_unstemmed | Refracture risk and all-cause mortality after vertebral fragility fractures: Anti-osteoporotic medications matter |
| title_short | Refracture risk and all-cause mortality after vertebral fragility fractures: Anti-osteoporotic medications matter |
| title_sort | refracture risk and all cause mortality after vertebral fragility fractures anti osteoporotic medications matter |
| topic | Vertebral fracture Osteoporosis Mortality |
| url | http://www.sciencedirect.com/science/article/pii/S0929664623001122 |
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