Antiresorptive Drugs and the Risk of Femoral Shaft Fracture in Men and Women With Osteoporosis: A Cohort Study Using the National Database of Health Insurance Claims of Japan
Background: This cohort study aimed to estimate incidence rates of femoral shaft fracture in patients who were treated with antiresorptive drugs. Methods: We used data from the National Database of Health Insurance Claims of Japan from April 2009 and October 2016. All patients with new use of an ant...
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| Format: | Article |
| Language: | English |
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Japan Epidemiological Association
2023-12-01
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| Series: | Journal of Epidemiology |
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| Online Access: | https://www.jstage.jst.go.jp/article/jea/33/12/33_JE20220099/_pdf |
| _version_ | 1797404586548396032 |
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| author | Takumi Imai Takayuki Hosoi Hiroshi Hagino Takanori Yamamoto Tatsuhiko Kuroda Hiroshi Watanabe Shiro Tanaka |
| author_facet | Takumi Imai Takayuki Hosoi Hiroshi Hagino Takanori Yamamoto Tatsuhiko Kuroda Hiroshi Watanabe Shiro Tanaka |
| author_sort | Takumi Imai |
| collection | DOAJ |
| description | Background: This cohort study aimed to estimate incidence rates of femoral shaft fracture in patients who were treated with antiresorptive drugs. Methods: We used data from the National Database of Health Insurance Claims of Japan from April 2009 and October 2016. All patients with new use of an antiresorptive drug, prescription-free period of ≥3 months, and no prior femoral fractures were included. Femoral shaft fractures were identified using a validated definition based on International Classification of Diseases, 10th revision (ICD-10) codes. Incidence rate ratios were estimated using Poisson regression, with adjustment for sex, age, and the Charlson Comorbidity Index. Results: We identified 7,958,655 patients (women: 88.4%; age ≥75 years: 51.2%). Femoral shaft fractures were identified in 22,604 patients. Incidence rates per 100,000 person-years were 74.8 for women, 30.1 for men, 30.1 for patients aged ≤64 years, 47.7 for patients aged 65–74 years, and 99.0 for patients aged ≥75 years. Adjusted incidence rate ratios in patients taking versus not taking each type of antiresorptive drug were 1.00 (95% confidence interval [CI], 0.98–1.03) for bisphosphonates, 0.46 (95% CI, 0.44–0.48) for selective estrogen receptor modulators, 0.24 (95% CI, 0.18–0.32) for estrogens, 0.75 (95% CI, 0.71–0.79) for calcitonins, and 0.93 (95% CI, 0.84–1.03) for denosumab. The adjusted incidence rate ratio for alendronate was 1.18 (95% CI, 1.14–1.22). Conclusion: The incidence rates of femoral shaft fracture varied across patients treated with different antiresorptive drugs. Further research on a specific antiresorptive drug can increase understanding of the risk of femoral shaft fracture. |
| first_indexed | 2024-03-09T02:57:10Z |
| format | Article |
| id | doaj.art-8e75d4c2df7143eabaf53852a50fb2f7 |
| institution | Directory Open Access Journal |
| issn | 0917-5040 1349-9092 |
| language | English |
| last_indexed | 2024-03-09T02:57:10Z |
| publishDate | 2023-12-01 |
| publisher | Japan Epidemiological Association |
| record_format | Article |
| series | Journal of Epidemiology |
| spelling | doaj.art-8e75d4c2df7143eabaf53852a50fb2f72023-12-05T03:40:42ZengJapan Epidemiological AssociationJournal of Epidemiology0917-50401349-90922023-12-01331263363910.2188/jea.JE20220099Antiresorptive Drugs and the Risk of Femoral Shaft Fracture in Men and Women With Osteoporosis: A Cohort Study Using the National Database of Health Insurance Claims of JapanTakumi Imai0Takayuki Hosoi1Hiroshi Hagino2Takanori Yamamoto3Tatsuhiko Kuroda4Hiroshi Watanabe5Shiro Tanaka6Department of Medical Statistics, Graduate School of Medicine, Osaka Metropolitan University, Osaka, JapanKenkoin Clinic, Tokyo, JapanSchool of Health Science, Tottori University Faculty of Medicine, Tottori, JapanMedical Affairs Capabilities, Japan Drug Development and Medical Affairs, Eli Lilly Japan K.K., Kobe, JapanPublic Health Research Foundation, Tokyo, JapanDepartment of Clinical Research and Development, National Center for Geriatrics and Gerontology, Aichi, JapanDepartment of Clinical Biostatistics, Graduate School of Medicine, Kyoto University, Kyoto, JapanBackground: This cohort study aimed to estimate incidence rates of femoral shaft fracture in patients who were treated with antiresorptive drugs. Methods: We used data from the National Database of Health Insurance Claims of Japan from April 2009 and October 2016. All patients with new use of an antiresorptive drug, prescription-free period of ≥3 months, and no prior femoral fractures were included. Femoral shaft fractures were identified using a validated definition based on International Classification of Diseases, 10th revision (ICD-10) codes. Incidence rate ratios were estimated using Poisson regression, with adjustment for sex, age, and the Charlson Comorbidity Index. Results: We identified 7,958,655 patients (women: 88.4%; age ≥75 years: 51.2%). Femoral shaft fractures were identified in 22,604 patients. Incidence rates per 100,000 person-years were 74.8 for women, 30.1 for men, 30.1 for patients aged ≤64 years, 47.7 for patients aged 65–74 years, and 99.0 for patients aged ≥75 years. Adjusted incidence rate ratios in patients taking versus not taking each type of antiresorptive drug were 1.00 (95% confidence interval [CI], 0.98–1.03) for bisphosphonates, 0.46 (95% CI, 0.44–0.48) for selective estrogen receptor modulators, 0.24 (95% CI, 0.18–0.32) for estrogens, 0.75 (95% CI, 0.71–0.79) for calcitonins, and 0.93 (95% CI, 0.84–1.03) for denosumab. The adjusted incidence rate ratio for alendronate was 1.18 (95% CI, 1.14–1.22). Conclusion: The incidence rates of femoral shaft fracture varied across patients treated with different antiresorptive drugs. Further research on a specific antiresorptive drug can increase understanding of the risk of femoral shaft fracture.https://www.jstage.jst.go.jp/article/jea/33/12/33_JE20220099/_pdfclaims databasefemoral shaft fractureosteoporosispharmacoepidemiologyjapanese population |
| spellingShingle | Takumi Imai Takayuki Hosoi Hiroshi Hagino Takanori Yamamoto Tatsuhiko Kuroda Hiroshi Watanabe Shiro Tanaka Antiresorptive Drugs and the Risk of Femoral Shaft Fracture in Men and Women With Osteoporosis: A Cohort Study Using the National Database of Health Insurance Claims of Japan Journal of Epidemiology claims database femoral shaft fracture osteoporosis pharmacoepidemiology japanese population |
| title | Antiresorptive Drugs and the Risk of Femoral Shaft Fracture in Men and Women With Osteoporosis: A Cohort Study Using the National Database of Health Insurance Claims of Japan |
| title_full | Antiresorptive Drugs and the Risk of Femoral Shaft Fracture in Men and Women With Osteoporosis: A Cohort Study Using the National Database of Health Insurance Claims of Japan |
| title_fullStr | Antiresorptive Drugs and the Risk of Femoral Shaft Fracture in Men and Women With Osteoporosis: A Cohort Study Using the National Database of Health Insurance Claims of Japan |
| title_full_unstemmed | Antiresorptive Drugs and the Risk of Femoral Shaft Fracture in Men and Women With Osteoporosis: A Cohort Study Using the National Database of Health Insurance Claims of Japan |
| title_short | Antiresorptive Drugs and the Risk of Femoral Shaft Fracture in Men and Women With Osteoporosis: A Cohort Study Using the National Database of Health Insurance Claims of Japan |
| title_sort | antiresorptive drugs and the risk of femoral shaft fracture in men and women with osteoporosis a cohort study using the national database of health insurance claims of japan |
| topic | claims database femoral shaft fracture osteoporosis pharmacoepidemiology japanese population |
| url | https://www.jstage.jst.go.jp/article/jea/33/12/33_JE20220099/_pdf |
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