Comparisons Between Different Anti-osteoporosis Medications on Postfracture Mortality: A Population-Based Study
Authors' conclusion
This real-world mega-data study suggests that the usage of osteoporotic medication, especially a long-acting regimen, may lower postfracture mortality.
Study context
- Population
- Subjects ≥40 years with osteoporotic fracture using anti-osteoporotic medications, Taiwan's National Health Insurance Research Database 2009–2017, followed until 2018; average age 74.45 years, 80.0% female
- Participants
- 46,729 subjects
- Exposure
- Different anti-osteoporosis medications vs raloxifene and bazedoxifene
- Outcome
- All-cause mortality
- Follow-up
- Mean 4.73 years
Methodological detailslongitudinal, multivariate Cox proportional hazards model with immortal time bias
- Longitudinal
- Multivariate Cox proportional hazards model with immortal time bias
Main finding
As reported in the abstract
Mortality, total fracture group
Each group vs raloxifene and bazedoxifeneHazard ratio (95% CI)
Alendronate/risedronate
0.83(0.79–0.88)
Denosumab
0.86(0.81–0.91)
Zoledronic acid
0.78(0.73–0.84)
Observational data: associations, not effects.
Further findings
Mortality by fracture site (hip, vertebral, nonhip/nonvertebral)
- Similar trends in the hip, vertebral, or nonhip/nonvertebral fracture groups
Mortality in subanalysis by sex or age over 65 years
- Long-acting zoledronic acid showed the lowest mortality
Original publication
Comparisons Between Different Anti-osteoporosis Medications on Postfracture Mortality: A Population-Based Study. J Clin Endocrinol Metab. Published 1 November 2022. doi:10.
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