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The Impact of Various Anti-Osteoporosis Drugs on All-Cause Mortality After Hip Fractures: A Nationwide Population Study |
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| Authors: | Ta-Wei Tai Jawl-Shan Hwang Chia-Chun Li Jason C. Hsu Chih-Wei Chang Chih-Hsing Wu |
| Affiliation: | 1. Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan;2. Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan Contribution: Conceptualization, Resources, Supervision;3. Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan Contribution: Data curation, Formal analysis, Methodology, Software, Validation;4. International PhD Program in Biotech and Healthcare Management, College of Management, Taipei Medical University, Taipei, Taiwan Clinical Data Center, Office of Data Science, Taipei Medical University, Taipei, Taiwan Research Center of Data Science on Healthcare Industry, College of Management, Taipei Medical University, Taipei, Taiwan Contribution: Data curation, Methodology, Supervision, Validation;5. Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan |
| Abstract: | Anti-osteoporosis treatment following hip fractures may reduce the overall mortality rate. However, the effects of different drugs on mortality is still unclear. This population-based cohort study aimed to identify the degree of reduced mortality after various anti-osteoporosis regimens following hip fracture surgery. We conducted this cohort study to identify patients with newly diagnosed osteoporosis and hip fractures from 2009 to 2017 using the Taiwan National Health Insurance Research Database (NHIRD). The subsequent use of anti-osteoporosis medication following hip fracture surgery was collected and analyzed. National death registration records were retrieved to determine mortality. A total of 45,226 new cases of osteoporotic hip fracture were identified. Compared with patients who did not receive further treatment, patients who had ever used oral bisphosphonates (alendronate and risedronate, hazard ratio [HR] 0.81; 95% confidence interval [CI], 0.78–0.84), ibandronate (HR 0.76; 95% CI, 0.67–0.86), zoledronic acid (HR 0.70; 95% CI, 0.64–0.76), and denosumab (HR 0.64; 95% CI, 0.60–0.68) showed lower all-cause mortality rates. Patients treated with bisphosphonates had a lower mortality risk than those treated with selective estrogen receptor modulators (HR 0.81; 95% CI, 0.75–0.87). Patients treated with zoledronic acid showed a lower mortality risk than those treated with oral bisphosphonates (HR 0.89; 95% CI, 0.82–0.97). However, patients receiving denosumab and zoledronic acid did not show a significant difference in mortality (HR 0.94; 95% CI, 0.85–1.03). Different anti-osteoporosis treatments for postsurgical patients were associated with different levels of decline in mortality. Generally, longer durations of drug use were associated with lower mortality. © 2022 American Society for Bone and Mineral Research (ASBMR). |
| Keywords: | HIP FRACTURE OSTEOPOROSIS MORTALITY |