A national study on long-term osteoporosis therapy and risk of recurrent fractures in patients with hip fracture

Abstract

ObjectiveThe study aimed to evaluate the impact of osteoporosis (OP) medication persistence on subsequent fractures and all-cause mortality in patients with hip fracture. MethodsIn this retrospective cohort study, we included patients aged ≥ 40 years with fragility hip fracture from the Taiwan’s National Health Insurance Research Database. OP medication persistence was categorized as yes (≥ 12 months) or no (< 12 months). A multivariate Cox proportional hazard model was used to evaluate the association between OP medication persistence and recurrent fractures (including hip, vertebral, and upper and lower limb fractures) and all-cause mortality. ResultsA total of 946 patients were included in the study (86.5 % of them aged ≥ 65 years) and 210 patients persistently received OP medications. Persistent OP medication use was associated with lower fracture risk (adjusted hazard ratio [aHR] = 0.64; 95 % CI = 0.41–0.99; P = .043) in the follow-up period. The strongest predictors for all-cause mortality were age ≥ 80 years (HR = 5.68, 95 % CI = 1.36–23.64, P = .017), male sex (HR = 1.55; 95 % CI = 1.18–2.03; P = .002), and Charlson Comorbidity Index ≥ 3 (aHR = 1.56; 95 % CI = 1.07–2.27; P = .022). Kaplan-Meier curves showed a lower cumulative incidence of recurrent fractures in the persistent group than that in the non-persistent group (P = .028). ConclusionPersistent OP medication use was associated with a lower risk of recurrent fractures but not with mortality in patients with hip fracture.