Mortality risk reduction differs according to bisphosphonate class: a 15-year observational study

Bliuc, D; Tran, T; van Geel, T; Adachi, JD; Berger, C; van den Bergh, J; Eisman, JA; Geusens, P; Goltzman, D; Hanley, DA; Josse, RG; Kaiser, S; Kovacs, CS; Langsetmo, L; Prior, JC; Nguyen, TV; Center, JR

Mortality risk reduction differs according to bisphosphonate class: a 15-year observational study

Bliuc, D Tran, T van Geel, T Adachi, JD Berger, C van den Bergh, J Eisman, JA Geusens, P Goltzman, D Hanley, DA Josse, RG Kaiser, S Kovacs, CS Langsetmo, L Prior, JC Nguyen, TV

Center, JR

Permalink

Publication Type:: Journal Article
Citation:: Osteoporosis International, 2019, 30 (4), pp. 817 - 828
Issue Date:: 2019-04-01

Closed Access

	Filename	Description	Size
	Bliuc2019_Article_MortalityRiskReductionDiffersA.pdf	Published Version	732.29 kB		View/Open

Copyright Clearance Process

Recently Added
In Progress
Closed Access

This item is closed access and not available.

Full metadata record

Field	Value	Language
dc.contributor.author	Bliuc, D	en_US
dc.contributor.author	Tran, T	en_US
dc.contributor.author	van Geel, T	en_US
dc.contributor.author	Adachi, JD	en_US
dc.contributor.author	Berger, C	en_US
dc.contributor.author	van den Bergh, J	en_US
dc.contributor.author	Eisman, JA	en_US
dc.contributor.author	Geusens, P	en_US
dc.contributor.author	Goltzman, D	en_US
dc.contributor.author	Hanley, DA	en_US
dc.contributor.author	Josse, RG	en_US
dc.contributor.author	Kaiser, S	en_US
dc.contributor.author	Kovacs, CS	en_US
dc.contributor.author	Langsetmo, L	en_US
dc.contributor.author	Prior, JC	en_US
dc.contributor.author	Nguyen, TV https://orcid.org/0000-0002-3246-6281	en_US
dc.contributor.author	Center, JR	en_US
dc.date.accessioned	2020-04-24T04:14:54Z
dc.date.available	2018-12-11	en_US
dc.date.available	2020-04-24T04:14:54Z
dc.date.issued	2019-04-01	en_US
dc.identifier.citation	Osteoporosis International, 2019, 30 (4), pp. 817 - 828	en_US
dc.identifier.issn	0937-941X	en_US
dc.identifier.uri	http://hdl.handle.net/10453/140260
dc.description.abstract	© 2019, International Osteoporosis Foundation and National Osteoporosis Foundation. Summary: In this prospective cohort of 6120 participants aged 50+, nitrogen-bisphosphonates but not non-nitrogen bisphosphonates were associated with a significant 34% mortality risk reduction compared to non-treated propensity score matched controls. These findings open new avenues for research into mechanistic pathways. Introduction: Emerging evidence suggests that bisphosphonates (BP), first-line treatment of osteoporosis, are associated with reduced risks for all-cause mortality. This study aimed to determine the association between different BP types and mortality risk in participants with or without a fracture. Methods: A prospective cohort study of users of different BPs matched to non-users by propensity score (age, gender, co-morbidities, fragility fracture status) and time to starting the BP medication from the population-based Canadian Multicentre Osteoporosis Study from nine Canadian centres followed from 1995 to 2013. Mortality risk for bisphosphonate users vs matched non-users was assessed using pairwise multivariable Cox proportional hazards models. Results: There were 2048 women and 308 men on BP and 1970 women and 1794 men who did not receive medication for osteoporosis. The relationship between BP and mortality risk was explored in three separate 1:1 propensity score-matched cohorts of BP users and no treatment (etidronate, n = 599, alendronate, n = 498, and risedronate n = 213). Nitrogen BP (n-BP) (alendronate and risedronate) was associated with lower mortality risks [pairwise HR, 0.66 (95% CI, 0.48–0.91)] while the less potent non-n-BP, etidronate, was not [pairwise HR: 0.89 (95% CI, 0.66–1.20)]. A direct comparison between n-BP and etidronate (n = 340 pairs) also suggested a better survival for n-BP [paired HR, 0.47 (95%CI, (95% CI, 031–0.70)] for n-BP vs. etidronate]. Conclusion: Compared to no treatment, nitrogen but not non-nitrogen bisphosphonates appear to be associated with better survival.	en_US
dc.relation.ispartof	Osteoporosis International	en_US
dc.relation.isbasedon	10.1007/s00198-018-4806-0	en_US
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject.classification	Endocrinology & Metabolism	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Alendronate	en_US
dc.subject.mesh	Bone Density Conservation Agents	en_US
dc.subject.mesh	Canada	en_US
dc.subject.mesh	Diphosphonates	en_US
dc.subject.mesh	Etidronic Acid	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Follow-Up Studies	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Kaplan-Meier Estimate	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Osteoporosis	en_US
dc.subject.mesh	Osteoporotic Fractures	en_US
dc.subject.mesh	Prospective Studies	en_US
dc.subject.mesh	Risedronic Acid	en_US
dc.subject.mesh	Risk Factors	en_US
dc.subject.mesh	Risk Reduction Behavior	en_US
dc.title	Mortality risk reduction differs according to bisphosphonate class: a 15-year observational study	en_US
dc.type	Journal Article
utslib.citation.volume	4	en_US
utslib.citation.volume	30	en_US
utslib.for	0903 Biomedical Engineering	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1117 Public Health and Health Services	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology/School of Biomedical Engineering
pubs.organisational-group	/University of Technology Sydney/Strength - CHT - Health Technologies
utslib.copyright.status	closed_access	*
pubs.issue	4	en_US
pubs.publication-status	Published	en_US
pubs.volume	30	en_US

Abstract:

© 2019, International Osteoporosis Foundation and National Osteoporosis Foundation. Summary: In this prospective cohort of 6120 participants aged 50+, nitrogen-bisphosphonates but not non-nitrogen bisphosphonates were associated with a significant 34% mortality risk reduction compared to non-treated propensity score matched controls. These findings open new avenues for research into mechanistic pathways. Introduction: Emerging evidence suggests that bisphosphonates (BP), first-line treatment of osteoporosis, are associated with reduced risks for all-cause mortality. This study aimed to determine the association between different BP types and mortality risk in participants with or without a fracture. Methods: A prospective cohort study of users of different BPs matched to non-users by propensity score (age, gender, co-morbidities, fragility fracture status) and time to starting the BP medication from the population-based Canadian Multicentre Osteoporosis Study from nine Canadian centres followed from 1995 to 2013. Mortality risk for bisphosphonate users vs matched non-users was assessed using pairwise multivariable Cox proportional hazards models. Results: There were 2048 women and 308 men on BP and 1970 women and 1794 men who did not receive medication for osteoporosis. The relationship between BP and mortality risk was explored in three separate 1:1 propensity score-matched cohorts of BP users and no treatment (etidronate, n = 599, alendronate, n = 498, and risedronate n = 213). Nitrogen BP (n-BP) (alendronate and risedronate) was associated with lower mortality risks [pairwise HR, 0.66 (95% CI, 0.48–0.91)] while the less potent non-n-BP, etidronate, was not [pairwise HR: 0.89 (95% CI, 0.66–1.20)]. A direct comparison between n-BP and etidronate (n = 340 pairs) also suggested a better survival for n-BP [paired HR, 0.47 (95%CI, (95% CI, 031–0.70)] for n-BP vs. etidronate]. Conclusion: Compared to no treatment, nitrogen but not non-nitrogen bisphosphonates appear to be associated with better survival.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/140260