Long Dosing Intervals of Parenteral Antiosteoporosis Medications and the Decrease in Societal Fracture Risk: A 11-Year Nationwide Population-Based Cohort Study

Shau-Huai Fu; Hung-Kuan Yen; Rong-Sen Yang; Chih-Chien Hung; Jou-Wei Lin; Ming-Tsung Lee; Ho-Min Chen; Chih-Hsing Wu; Chih-Cheng Hsu; Chung-Yi Li; Olivier Q Groot; Chen-Yu Wang

doi:10.1016/j.mayocp.2024.05.002

Long Dosing Intervals of Parenteral Antiosteoporosis Medications and the Decrease in Societal Fracture Risk: A 11-Year Nationwide Population-Based Cohort Study

Mayo Clin Proc. 2024 Dec 4:S0025-6196(24)00247-7. doi: 10.1016/j.mayocp.2024.05.002. Online ahead of print.

Authors

Shau-Huai Fu¹, Hung-Kuan Yen², Rong-Sen Yang³, Chih-Chien Hung⁴, Jou-Wei Lin⁵, Ming-Tsung Lee⁶, Ho-Min Chen⁷, Chih-Hsing Wu⁸, Chih-Cheng Hsu⁹, Chung-Yi Li¹⁰, Olivier Q Groot¹¹, Chen-Yu Wang¹²

Affiliations

¹ Department of Orthopedics, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
² Department of Medical Education, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan; Department of Orthopaedic Surgery, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan.
³ Department of Orthopedics, National Taiwan University Hospital, Taipei, Taiwan.
⁴ Department of Orthopedics, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan.
⁵ Cardiovascular Center, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan.
⁶ National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin County, Taiwan; Department of Nursing, Hungkuang University, Taichung, Taiwan.
⁷ Health Data Research Center, National Taiwan University Hospital, Taipei, Taiwan.
⁸ Department of Family Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Geriatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁹ National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin County, Taiwan.
¹⁰ Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Public Health, China Medical University, Taichung 406040, Taiwan; Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan.
¹¹ Department of Orthopaedics, University Medical Center Utrecht, Utrecht, Netherlands; Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
¹² Department of Pharmacy, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan; National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin County, Taiwan. Electronic address: [email protected].

PMID: 39665727
DOI: 10.1016/j.mayocp.2024.05.002

Abstract

Objective: To evaluate the relationship between different dosing intervals of antiosteoporosis medications (AOMs) and the subsequent fracture risk among patients with newly initiated AOM therapies.

Patients and methods: In a nationwide population-based cohort study based on Taiwan's National Health Insurance Research Database, osteoporosis patients with 50 years of age or older who newly initiated AOM from January 1, 2008, to December 31, 2018 (n=336,229) were included. We categorized AOMs into short dosing intervals (oral AOMs) or long dosing intervals (parenteral AOMs). The adherence of treatment by medication possession ratio and subsequent fracture after treatment for 3 years were measured.

Results: Among patients who initiated parenteral AOMs, the percentage of patients with high adherence (medication possession ratio ≥75%) increased from 33% in 2008 to 69% in 2018. However, among patients who initiated oral AOMs, the percentage of high adherence remained stable (30%) between 2008 and 2018. The use of parenteral AOMs increased from 1% in 2008 to 62% in 2018. At the same time, the percentage of high adherence of those initiated AOMs significantly increased from 34% in 2008 to 61% in 2018. The risk of subsequent fracture decreased significantly between 2008 and 2018 after controlling for all potential confounders (HR, 0.85; 95% CI, 0.81 to 0.89).

Conclusion: AOMs with long dosing intervals not only increased adherence but also associated with the decrease in subsequent fracture risk at a nationwide scale.