台湾地区骨质疏松性髋关节炎伴骨质疏松症患者抗骨质疏松药物对全髋关节置换术风险的影响：一项全国性队列研究。

Effects of anti-osteoporosis medications on total hip arthroplasty risks in osteoporotic patients with hip osteoarthritis in Taiwan: a nationwide cohort study.

机构信息

Department of Orthopedics, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin County, Taiwan.

Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.

出版信息

Arch Osteoporos. 2018 Oct 10;13(1):107. doi: 10.1007/s11657-018-0522-9.

DOI:10.1007/s11657-018-0522-9

PMID:30306268

Abstract

UNLABELLED

This nationwide cohort study examined the potential disease-modifying effect of anti-osteoporosis medication on hip osteoarthritis. The results revealed that the usage of anti-osteoporosis medication is not associated with decreased risk in undergoing total hip arthroplasty in patient with hip osteoarthritis.

PURPOSE

This study aimed to assess the association between use of anti-osteoporosis medications (AOMs) and the risk of undergoing total hip arthroplasty (THA) in patients with hip osteoarthritis (OA).

METHODS

Using the 2008-2013 National Health Insurance Research Database, we identified patients who were first diagnosed as having hip OA. All identified patients were followed until THA, death of any cause, or December 31, 2013, whichever occurred first. All AOM exposures were divided into three categories: bisphosphonates use, non-bisphosphonates use, and no use of AOMs and assessed in a time-varying manners. The primary outcome was THA. The secondary outcome was the differences in the longitudinal utilization of NSAIDs between AOM users and non-users. Time-dependent Cox proportional hazards models were used to investigate the effect of AOM use on the risk of THA.

RESULTS

We identified 35,870 patients who were first diagnosed as having hip OA and had no history of AOM use between 2009 and 2012. Among them, 3162 and 1667 patients had their first prescription of bisphosphonates and other non-bisphosphonates AOMs during the follow-up period. Mean age of bisphosphonates users, non-bisphosphonates users, and non-users was 75.62, 76.84, and 67.39 years, respectively. Bisphosphonates or non-bisphosphonates users did not show significant change when compared to non-users in terms of risk of undergoing THA [adjusted hazard ratio (aHR) 0.972, 95% confidence interval (CI) 0.743-1.273; aHR 0.926, 95% CI 0.672-1.277].

CONCLUSION

Our results showed that the use of AOMs is not associated with decreased risk of THA in patients with hip OA.

摘要

未加标签

本全国性队列研究考察了抗骨质疏松药物对髋关节炎的潜在疾病修饰作用。结果表明，髋关节炎患者使用抗骨质疏松药物与全髋关节置换术风险降低无关。

目的

本研究旨在评估抗骨质疏松药物（AOM）的使用与髋关节炎（OA）患者接受全髋关节置换术（THA）风险之间的关系。

方法

使用 2008-2013 年全国健康保险研究数据库，我们确定了首次被诊断为髋 OA 的患者。所有确定的患者均随访至接受 THA、任何原因死亡或 2013 年 12 月 31 日，以先发生者为准。所有 AOM 暴露均分为三类：双膦酸盐使用、非双膦酸盐使用和未使用 AOM，并以时变方式进行评估。主要结局为 THA。次要结局为 AOM 使用者和未使用者 NSAIDs 纵向使用的差异。采用时间依赖性 Cox 比例风险模型探讨 AOM 使用对 THA 风险的影响。

结果

我们确定了 35870 名在 2009 年至 2012 年期间无 AOM 使用史的首次被诊断为髋 OA 的患者。其中 3162 例和 1667 例患者在随访期间首次开了双膦酸盐和其他非双膦酸盐 AOM。双膦酸盐使用者、非双膦酸盐使用者和未使用者的平均年龄分别为 75.62、76.84 和 67.39 岁。与未使用者相比，双膦酸盐或非双膦酸盐使用者在接受 THA 的风险方面没有显著变化[调整后的危险比（aHR）0.972，95%置信区间（CI）0.743-1.273；aHR 0.926，95% CI 0.672-1.277]。