Kostoff MD, Saseen JJ, Borgelt LM. Evaluation of fracture risk and potential drug holidays for postmenopausal women on long-term bisphosphonate therapy.
Int J Womens Health 2014;
6:423-8. [PMID:
24855392 PMCID:
PMC4010634 DOI:
10.2147/ijwh.s57549]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Study objective
To describe characteristics of postmenopausal women on long-term bisphosphonate therapy who fall into one of four fracture risk categories (low, mild, moderate, high), and to determine the prevalence of women eligible for a drug holiday.
Design
Retrospective electronic health record review.
Setting
Eight primary care clinics within a university-based health care system.
Patients
A total of 201 postmenopausal women of ages 55–89 years, with osteopenia or osteoporosis, prescribed bisphosphonate therapy for >4 years, between October 10, 2002 and September 9, 2012.
Main results
The patients’ mean age was 71.4 (±8.2) years; their mean body mass index was 25.3 (±5.6) kg/m2; and 73.1% were white. Seventy-four out of 201 patients (36.8%) were low-risk; 10/201 (5.0%) were mild-risk; 72/201 (35.8%) were moderate-risk; and 45/201 (22.4%) were high-risk. Eighty-one women (40.3%) were eligible for a drug holiday or discontinuation. The estimated drug cost avoided per eligible patient was $574.80. Calcium and/or vitamin D supplementation was documented in 52.7% of women.
Conclusion
More than one-third of postmenopausal women taking long-term bisphosphonate therapy had low fracture risk, and over 40% of our patients were eligible for a drug holiday or discontinuation. These data emphasize the need to accurately assess risk and benefit in patients treated with bisphosphonate therapy.
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