Bisphosphonate Use and Hospitalization for Hip Fractures in Women: An Observational Population-Based Study in France

Bastien Bourrion, Cécile Souty, Lucie Fournier, Ana-Maria Vilcu, Thierry Blanchon, Pierre-Yves Böelle, Thomas Hanslik and Mathilde François
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Bastien Bourrion: Institut Pierre-Louis d’Epidémiologie et de Santé Publique (IPLESP UMRS 1136), INSERM, Sorbonne Université, 75012 Paris, France
Cécile Souty: Institut Pierre-Louis d’Epidémiologie et de Santé Publique (IPLESP UMRS 1136), INSERM, Sorbonne Université, 75012 Paris, France
Lucie Fournier: Institut Pierre-Louis d’Epidémiologie et de Santé Publique (IPLESP UMRS 1136), INSERM, Sorbonne Université, 75012 Paris, France
Ana-Maria Vilcu: Institut Pierre-Louis d’Epidémiologie et de Santé Publique (IPLESP UMRS 1136), INSERM, Sorbonne Université, 75012 Paris, France
Thierry Blanchon: Institut Pierre-Louis d’Epidémiologie et de Santé Publique (IPLESP UMRS 1136), INSERM, Sorbonne Université, 75012 Paris, France
Pierre-Yves Böelle: Institut Pierre-Louis d’Epidémiologie et de Santé Publique (IPLESP UMRS 1136), INSERM, Sorbonne Université, 75012 Paris, France
Thomas Hanslik: Institut Pierre-Louis d’Epidémiologie et de Santé Publique (IPLESP UMRS 1136), INSERM, Sorbonne Université, 75012 Paris, France
Mathilde François: Institut Pierre-Louis d’Epidémiologie et de Santé Publique (IPLESP UMRS 1136), INSERM, Sorbonne Université, 75012 Paris, France

IJERPH, 2021, vol. 18, issue 16, 1-11

Abstract: Bisphosphonates are widely used in the treatment of women at risk of osteoporotic hip fracture; however, the overall effectiveness of bisphosphonates in the prevention of osteoporotic fractures has not been studied in real life. To investigate whether the use of bisphosphonates in women aged 50 years and over is associated with a decrease in hospitalization for osteoporotic hip fractures, a historical prospective cohort study was conducted between 2009 and 2016 from a permanent representative sample consisting of 1/97 of the French health insurance beneficiaries. Bisphosphonate use was defined according to medication persistence and adherence regarding bisphosphonate dispensations. The primary outcome was the hospitalization rate for osteoporotic hip fracture. Among the 81,268 women included, 2005 were exposed to bisphosphonates. The median time of bisphosphonate exposure was 12 (IQR, 3–29) and 17 (IQR, 5–42) months for the persistence and adherence definitions, respectively. Exposure to bisphosphonates was not associated with a decrease in hospitalization for hip fracture: weighted HRadherence = 0.66 (95% CI, 0.33 to 1.33); HRpersistance = 0.77 (95% CI, 0.38 to 1.57). In real life, bisphosphonate use does not appear to reduce hospitalization for hip fractures, as to date, it is probably prescribed as primary prevention and for a duration too short to be effective.

Keywords: osteoporosis; hip fractures; bisphosphonates; hospitalization (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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