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- Title
Association between pharmacotherapy and secondary vertebral fracture managed with a brace in a real-world setting: A nationwide database study in Japan.
- Authors
Shinichi Nakatoh; Kenji Fujimori; Shigeyuki Ishii; Junko Tamaki; Nobukazu Okimoto; Sumito Ogawa; Masayuki Iki
- Abstract
Aim: This retrospective cohort study assessed the association between the incidence of secondary vertebral fracture managed with a brace (SVF) and pharmacotherapy. Methods: The association between the incidence of SVF and the presence, type, and medication possession ratio (MPR) of pharmacotherapy was investigated using medical insurance data acquired from the National Database of Health Insurance Claims and Specific Health Checkups of Japan. Results: The data of female patients (n = 637 303) were analyzed. The 2-year incidence of SVF was 73.5 per 10 000 patients (n = 4687). Approximately 0.73% of patients without medications and 0.74% with medications had SVF. Patients taking bisphosphonates (0.87), denosumab (0.77), and selective estrogen receptor modulators (0.88) had significantly lower standardized incidence ratios (SIRs) than patients not taking medications after the occurrence of primary fracture; meanwhile, patients taking parathyroid hormone medications had considerably higher SIRs than those not taking medications. The non-SVF group (59.1%) had a significantly higher mean MPR than the SVF group (55.5%). Patients taking denosumab in the non-SVF group (68.2%) had the highest mean MPR. The proportion of patients taking denosumab with an MPR of =80% in the non-SVF group was significantly higher than that in the SVF group. Conclusion: Patients taking medications were at a lower risk of developing SVF than those not taking medications. Although this study did not compare the medications' SVF prevention effects, patients taking denosumab had a 0.77 SIR of SVF in Japan. The effect of pharmacotherapy on SVF prevention might be affected by the MPR of each medication.
- Subjects
JAPAN; PATIENT compliance; RISK assessment; DIPHOSPHONATES; RESEARCH funding; HEALTH insurance; VERTEBRAL fractures; ORTHOPEDIC apparatus; RETROSPECTIVE studies; DESCRIPTIVE statistics; LONGITUDINAL method; MONOCLONAL antibodies; MEDICAL records; ACQUISITION of data; DRUGS; DISEASE risk factors
- Publication
Geriatrics & Gerontology International, 2024, Vol 24, Issue 4, p390
- ISSN
1444-1586
- Publication type
Article
- DOI
10.1111/ggi.14853