Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, NTNU, Trondheim, Norway.
Department of Public Health and Nursing, Norwegian University of Science and Technology, NTNU, Trondheim, Norway.
Osteoporos Int. 2021 Jul;32(7):1395-1404. doi: 10.1007/s00198-021-05845-2. Epub 2021 Jan 21.
Bisphosphonates reduce fractures in randomized controlled trials (RCT); however, there is less information from real life. In our population including 14,990 women and 13,239 men, use of bisphosphonates reduced risk of fractures in hip and forearm in women. The magnitude of the effect was comparable to results from RCT.
The objective was to examine if treatment with bisphosphonates (BPs) was associated with reduced risk of fractures in the hip and forearm in women and men in the general population.
In a cohort study based on data from the third wave of the population-based HUNT Study (HUNT3), the fracture registry in Nord-Trøndelag, and the Norwegian Prescription Database, 14,990 women and 13,239 men 50-85 years were followed from the date of participating in HUNT3 (2006-2008) until the date of first fracture in the hip or forearm, death, or end of study (31 December 2012). Hazard ratios with 95% confidence intervals for hip and forearm fracture according to use of BPs were estimated using Cox proportional hazards models with time-dependent exposure. Adjustment for individual FRAX® fracture risk assessment scores was included.
BPs, predominantly alendronate, were used by 9.4% of the women and 1.5% of the men. During a median of 5.2 years of follow-up, 265 women and 133 men had a hip fracture, and 662 women and 127 men had a forearm fracture. Compared with non-users of BPs, the hazard ratios with 95% confidence interval for a fracture among users of BPs adjusted for age and FRAX® were 0.67 (0.52-0.86) for women and 1.13 (0.50-2.57) for men. Among users of glucocorticoids, the corresponding figures were 0.35 (0.19-0.66) and 1.16 (0.33-4.09), respectively.
Use of BPs was associated with reduced risk of fractures in hip and forearm in women, and the magnitude of effect is comparable to results from RCTs.
双磷酸盐类药物在随机对照试验（RCT）中降低骨折风险；然而，实际生活中的信息较少。在我们的研究人群中，包括 14990 名女性和 13239 名男性，使用双磷酸盐类药物降低了女性髋部和前臂骨折的风险。其影响的幅度与 RCT 的结果相当。
目的是研究在普通人群中，双磷酸盐类药物（BPs）治疗是否与女性和男性髋部和前臂骨折风险降低相关。
基于第三波基于人群的亨氏研究（HUNT3）、诺尔兰骨折登记处和挪威处方数据库的数据，我们进行了一项队列研究，纳入了 14990 名 50-85 岁的女性和 13239 名男性，从参加 HUNT3（2006-2008 年）的日期开始随访，直至髋部或前臂发生首次骨折、死亡或研究结束（2012 年 12 月 31 日）。使用时依cox 比例风险模型，以时间依赖性暴露的方式估计了双磷酸盐类药物使用与髋部和前臂骨折的风险比（HR）及其 95%置信区间（CI）。纳入了个体 FRAX®骨折风险评估评分的调整。
双磷酸盐类药物，主要是阿仑膦酸钠，在 9.4%的女性和 1.5%的男性中使用。在中位数为 5.2 年的随访期间，265 名女性和 133 名男性发生髋部骨折，662 名女性和 127 名男性发生前臂骨折。与未使用双磷酸盐类药物的患者相比，经年龄和 FRAX®调整后，使用双磷酸盐类药物患者的骨折风险比（HR）及其 95%CI 为 0.67（0.52-0.86）（女性）和 1.13（0.50-2.57）（男性）。在使用糖皮质激素的患者中，相应的数字分别为 0.35（0.19-0.66）和 1.16（0.33-4.09）。
在女性中，使用双磷酸盐类药物与髋部和前臂骨折风险降低相关，其影响幅度与 RCT 的结果相当。
