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

Dana Bliuc; T. Tran; T. van Geel; J. D. Adachi; C. Berger; J. van den Bergh; J. A. Eisman; P. Geusens; D. Goltzman; D. A. Hanley; R. G. Josse; S. Kaiser; C. S. Kovacs; L. Langsetmo; J. C. Prior; T. V. Nguyen; J. Center

doi:10.1007/s00198-018-4806-0

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

Dana Bliuc
, T. Tran
, T. van Geel
, J. D. Adachi
, C. Berger
, J. van den Bergh
, J. A. Eisman
, P. Geusens
, D. Goltzman
, D. A. Hanley
, R. G. Josse
, S. Kaiser
, C. S. Kovacs
, L. Langsetmo
, J. C. Prior
, T. V. Nguyen
, J. Center

Garvan Institute of Medical Research, Sydney
Maastricht University Care and Public Health Research Institute
McMaster University, Hamilton
McGill University, Montreal, Canada
Maastricht University Medical Center
Garvan Institute of Medical Research
University of Calgary
University of Toronto
Dalhousie University, Halifax, Canada
Memorial University of Newfoundland
University of Minnesota, USA
University of British Columbia

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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.

Iaith wreiddiol	Saesneg
Tudalennau (o-i)	817-828
Cyfnodolyn	Osteoporosis International
Cyfrol	30
Rhif cyhoeddi	4
Dyddiad ar-lein cynnar	3 Ion 2019
Dynodwyr Gwrthrych Digidol (DOIs)	https://doi.org/10.1007/s00198-018-4806-0
Statws	E-gyhoeddi cyn argraffu - 3 Ion 2019
Cyhoeddwyd yn allanol	Ie

Mynediad at Ddogfen

10.1007/s00198-018-4806-0

Dyfynnu hyn

Bliuc, D., Tran, T., van Geel, T., Adachi, J. D., Berger, C., van den Bergh, J., Eisman, J. A., Geusens, P., Goltzman, D., Hanley, D. A., Josse, R. G., Kaiser, S., Kovacs, C. S., Langsetmo, L., Prior, J. C., Nguyen, T. V., & Center, J. (2019). Mortality risk reduction differs according to bisphosphonate class: a 15-year observational study. Osteoporosis International, 30(4), 817-828. Cyhoeddiad ar-lein ymlaen llaw. https://doi.org/10.1007/s00198-018-4806-0

@article{f2356c1486d64a1198c7361212c10358,

title = "Mortality risk reduction differs according to bisphosphonate class: a 15-year observational study",

abstract = "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.",

author = "Dana Bliuc and T. Tran and \{van Geel\}, T. and Adachi, \{J. D.\} and C. Berger and \{van den Bergh\}, J. and Eisman, \{J. A.\} and P. Geusens and D. Goltzman and Hanley, \{D. A.\} and Josse, \{R. G.\} and S. Kaiser and Kovacs, \{C. S.\} and L. Langsetmo and Prior, \{J. C.\} and Nguyen, \{T. V.\} and J. Center",

year = "2019",

month = jan,

day = "3",

doi = "10.1007/s00198-018-4806-0",

language = "English",

volume = "30",

pages = "817--828",

journal = "Osteoporosis International",

issn = "0937-941X",

publisher = "Springer Science and Business Media Deutschland GmbH",

number = "4",

}

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, J 2019, 'Mortality risk reduction differs according to bisphosphonate class: a 15-year observational study', Osteoporosis International, cyfrol. 30, rhif 4, tt. 817-828. https://doi.org/10.1007/s00198-018-4806-0

TY - JOUR

T1 - Mortality risk reduction differs according to bisphosphonate class: a 15-year observational study

AU - Bliuc, Dana

AU - Tran, T.

AU - van Geel, T.

AU - Adachi, J. D.

AU - Berger, C.

AU - van den Bergh, J.

AU - Eisman, J. A.

AU - Geusens, P.

AU - Goltzman, D.

AU - Hanley, D. A.

AU - Josse, R. G.

AU - Kaiser, S.

AU - Kovacs, C. S.

AU - Langsetmo, L.

AU - Prior, J. C.

AU - Nguyen, T. V.

AU - Center, J.

PY - 2019/1/3

Y1 - 2019/1/3

N2 - 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.

AB - 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.

U2 - 10.1007/s00198-018-4806-0

DO - 10.1007/s00198-018-4806-0

M3 - Article

SN - 0937-941X

VL - 30

SP - 817

EP - 828

JO - Osteoporosis International

JF - Osteoporosis International

IS - 4

ER -

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

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