Fractures among postmenopausal women with osteoporosis in Taiwan – A head-to-head comparison between patients continuing on bisphosphonates vs transitioning to denosumab

Abstract

Osteoporosis is a silent disease with increasing prevalence due to aging population Randomized clinical trial demonstrated that patients transitioned to denosumab had better results of bone mineral density compared to patients continued on alendronate However risk profiles of fractures between groups remained uncertain We conducted a retrospective cohort study using the Taiwan’s National Health Insurance Database (NHID) from 2005-2015 Study population consisted of postmenopausal women aged over 55 years diagnosed with osteoporosis We selected patients who transitioned from bisphosphonates to denosumab and matched patients continued on bisphosphonates with 30 days before and after the cohort entry We compared the risk of hospitalization due to hip fracture vertebral fracture and other fractures including wrist or humerus fractures between two groups We performed Cox proportional hazard model with adjustment of covariates including age history of fractures history of comorbidities and medication use to compare fracture risk between groups We included a total of 12 365 patients transitioning to denosumab and matched to 12 365 patients continuing on bisphosphonates We found patients transitioning to denosumab posed lower risk of hip fracture (adjusted HR 0 39; 95% CI 0 30-0 51) and vertebral fracture (0 67; 0 56-0 81) Compared with patients continuing on bisphosphonates the risk of other fractures was similar between groups (0 90; 0 60-1 35) The findings indicated transitioning to denosumab might provide favorable profile in fracture risk in postmenopausal women with osteoporosis

Date of Award	2019
Original language	English
Supervisor	Yea-Huei Kao (Supervisor)