Decreased Osteoporosis Treatment Initiation Observed After Hip Fracture

x-ray of pelvis and fracture
x-ray of pelvis and fracture
Researchers observed a reduction in subsequent nonvertebral fracture rates in patients who initiated osteoporosis treatment.

Rates of osteoporosis treatment initiation after a hip fracture have decreased in recent years, according to a study published in JAMA Network Open.

Researchers examined rates of osteoporosis treatment initiation between January 1, 2004, and September 30, 2015 from a US commercial insurance claims database. The goal was to study the risk reduction in subsequent nonvertebral fractures associated with treatment initiation in patients with hip fracture.  The cohort study included 97,169 individuals older than 50 years who had a hip fracture but were not receiving treatment with osteoporosis medications prior to their fracture.

A decline was noted in initiation rates of osteoporosis medication from 9.8% (95% CI, 9.0%-10.6%) in 2004 to 3.3% (95% CI, 2.9%-3.8%) in 2015. Researchers also documented a clinically meaningful reduction in subsequent nonvertebral fracture rates of approximately 4.2 events per 100 person-years among patients who initiated osteoporosis treatment compared with nonusers in a variable analysis. 

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The subsequent reduction in nonvertebral fracture rates associated with treatment suggest that improving prescriber adherence to recommended guidelines of osteoporosis medication and patient adherence to their prescribed dosing regimen is warranted.

This study was supported by Merck & Co. Please refer to the original article for a complete list of authors’ disclosures.

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Desai RJ, Mahesri M, Abdia Y, et al. Association of osteoporosis medication use after hip fracture with prevention of subsequent nonvertebral fractures: An instrumental variable analysis [published online July 20, 2018]. JAMA Netw Open. doi:10.1001/jamanetworkopen.2018.0826