Bisphosphonate use and subsequent hip fracture in South Korea.

Abstract

UNLABELLED:

We determined the incidence of second hip fracture and evaluated whether compliant and persistent users of bisphosphonate had a lower incidence of second hip fracture after prior hip fracture, from a national claim registry.

INTRODUCTION:

Bisphosphonate is prescribed worldwide for the primary prevention of osteoporotic fracture. However, the association between adherent use of bisphosphonate and prevention of second hip fracture is unclear. Our purpose was to determine whether the adherent use of bisphosphonate was associated with a decreased risk of second hip fracture in South Korea, using a nationwide database.

METHODS:

From 2007 to 2011, first and second hip fractures were identified using the ICD-10 and procedure code form from the nationwide database of the Health Insurance Review and Assessment Service. Compliant use of bisphosphonate was defined as a patient medication possession ratio of 80 or more. Persistent users were defined patients with a refill gap of 30 days or less. We compared the incidence of second hip fracture in compliant and persistent users and non-users.

RESULTS:

Among 59,782 patients with first hip fracture, in this study, 1,336 second hip fracture occurred after the initial hip fracture during the study period. The mean age at the first hip fracture was 75.4 years (range, 50 to 100 years). The cumulative 1-year, 2-year, and 3-year incidence of second hip fracture was 1.0% (552/59,782), 1.9% (1,123/59,782), and 2.2% (1,336/59,782), respectively. After multivariate analysis, compliant and persistent use of bisphosphonate was significantly independent protectors for second hip fracture (HR, 0.595; 95% CI, 0.400-0.885; HR, 0.433; 95% CI, 0.327-0.573, respectively).

CONCLUSIONS:

Compliant and persistent use of bisphosphonate decreases the risk of second hip fracture, in terms of secondary prevention.

• Authors: Y-K Lee, Y-C Ha, H J Choi, S Jang, C Park, Y-T Lim, C S Shin
• Journal: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA (Osteoporos Int) Vol. 24 Issue 11 Pg. 2887-92 (Nov 2013) ISSN: 1433-2965 [Electronic] England
• PMID: 23681088 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Bone Density Conservation Agents
• Diphosphonates

Topics

• Age Distribution
• Aged
• Aged, 80 and over
• Bone Density Conservation Agents (therapeutic use)
• Databases, Factual
• Diphosphonates (therapeutic use)
• Female
• Hip Fractures (epidemiology, prevention & control)
• Humans
• Incidence
• Male
• Medication Adherence (statistics & numerical data)
• Middle Aged
• Osteoporosis (drug therapy, epidemiology)
• Osteoporotic Fractures (epidemiology, prevention & control)
• Republic of Korea (epidemiology)
• Retrospective Studies
• Secondary Prevention
• Sex Distribution