Purpose: While pharmacological intervention does help reduce the risk of total mortality induced by osteoporotic fracture, few studies have been conducted to examine the impact of specific drugs, especially bisphosphonates, on osteoporotic fractures in Taiwan. Therefore, the study aimed to analyze the relationship between the use of bisphosphonates for osteoporotic fractures and resulting mortality.
Methods: The National Health Insurance Research Database (NHIRD), together with the Cause of Death Data, provided by Health and Welfare Data Science Center was consulted for analysis on subjects hospitalized for osteoporotic fracture from 2009 to 2017 to study the connection between the use of bisphosphonates and mortality among patients with osteoporotic fracture.
Results: A total of 149,288 valid participants were enrolled, and the mean follow-up personyears of the survivor and death were respectively 4.96 and 3.15. Compared with those who used no bisphosphonates, the mortality hazard ratio was 0.97 (95% confidence interval, CI 0.95-0.99)for patients receiving bisphosphonates, 1.01 (95% CI 0.99-1.03) for oral alendronate/risedronate, 0.87 (95% CI 0.81-0.93) for ibandronate by injection, and 0.74 (95% CI 0.70-0.78) for zoledronic acid in total fractures. Consistent results were found in subgroup-analysis of hip fractures or spine fractures.
Conclusion: Use of bisphosphonates, especially through injection, appears to be significantly associated with reduced mortality in patients with osteoporotic fractures. The result of this study should be considered in clinical practice and public policy.