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Alendronate use and...
Alendronate use and the risk of nonvertebral fracture during glucocorticoid therapy : a retrospective cohort study
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- Bergman, Jonathan (författare)
- Umeå universitet,Geriatrik
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- Nordström, Anna (författare)
- Umeå universitet,Yrkes- och miljömedicin
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- Nordström, Peter (författare)
- Umeå universitet,Geriatrik
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(creator_code:org_t)
- 2017-11-03
- 2018
- Engelska.
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Ingår i: Journal of Clinical Endocrinology and Metabolism. - Cary : Oxford University Press. - 0021-972X .- 1945-7197. ; 103:1, s. 306-313
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https://academic.oup...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Context: Glucocorticoids increase the risk of nonvertebral fracture, but no clinical trial has shown that nonvertebral fractures can be prevented by co-administration of an anti-osteoporotic drug.Objective: To estimate the effect of alendronate on the risk of nonvertebral fracture in older adults taking oral glucocorticoids.Design: Retrospective cohort study using national Swedish registers.Setting: Hospitalized care and ambulatory specialist care.Patients: Among adults aged 50 years or older (N=3,347,959), we identified those who initiated oral glucocorticoid therapy from 2006 through 2011 (≥2.5 mg/day of prednisone or equivalent for ≥91 days). The final analysis included 16,890 alendronate users and 16,890 nonusers, who were matched using time-dependent propensity scores.Main Outcome Measure: Nonvertebral fracture. This was not pre-specified.Results: Over a median follow-up of 14.5 months, the incidence rate of nonvertebral fracture was 2.0 cases per 100 person-years in alendronate users and 2.4 cases in nonusers. This difference corresponded to a 16% lower rate in users (hazard ratio 0.84, 95% confidence interval 0.75 to 0.94). For hip fractures specifically, the rate was 34% lower in alendronate users relative to nonusers (hazard ratio 0.66, 95% confidence interval 0.55 to 0.78). The association of alendronate use with a lower risk of nonvertebral fracture was strongest in patients who received high doses of glucocorticoid.Conclusion: Alendronate use was associated with a lower risk of nonvertebral fracture, including hip fracture. Similar, but not statistically significant, associations have been reported in meta-analyses of clinical trials.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
Nyckelord
- bone-mineral density
- induced osteoporosis
- postmenopausal women
- vertebral fracture
- double-blind
- metaanalysis
- prevention
- prevalence
- trial
- efficacy
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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