Changing trends in bisphosphonate therapy: a twenty-five-year surveillance in a single US integrated healthcare system
Authors' conclusion
In a large primary care population of adults initiating BP, greater treatment of older adults and those with prior fracture highlights the key role of targeted fracture prevention initiatives, sustaining treatment efforts.
Study context
- Population
- Adults aged 50–89 years initiating alendronate, risedronate, ibandronate or zoledronate in Kaiser Permanente Northern California, 1998–202286.0% women
- Participants
- 212,289 adults
- Exposure
- Women vs Men
- Outcome
- Proportion of BP initiators aged < 65 years, successive 5-year periods (1998-2022)
Methodological detailssingle integrated healthcare system, trends across 5-year periods
- Single integrated healthcare system
- Trends across 5-year periods
Main finding
As reported in the abstract
Women aged < 65 years
35.1%, 35.2%, 24.1%, 18.8%, and 17.8%
Men aged < 65 years
26.9%, 25.4%, 17.6%, 12.6%, and 4.7%
Observational data: associations, not effects.
Further findings
Prior fracture among bisphosphonate (BP) initiators
- Women, 1998-2007
- 21-24%
- Women, 2008-2022 (after secondary fracture prevention program for women in 2008)
- 35-38%
- Men, successive 5-year periods 1998-2017
- 28 to 37%, 40%, and 47%
- Men, 2018-2022 (after BMD screening targeted older men)
- 26%
- Secondary fracture prevention program for men began in 2015
Numbers initiating BP in later years
- Sustained or increasing numbers coincided with electronic health record targets for BMD screening (since 2016 for women, 2017-2019 for men), an impact greater for men
Original publication
Changing trends in bisphosphonate therapy: a twenty-five-year surveillance in a single US integrated healthcare system. Osteoporos Int. Published 7 February 2025. doi:10. 1007/ s00198-024-07372-2
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