Osteoporosis medication reduces mortality risk in elderly women and men

January 01, 0001

Osteoporosis medication reduces mortality risk in elderly women and men

Osteoporotic fractures are associated with premature mortality. Antiresorptive treatment reduces refracture but mortality reduction is unclear. The objective of this prospective cohort study (April 1989 to May 2007). by researchers from Australia was to examine the effect of osteoporosis treatment, bisphosphonates (BP), hormone therapy (HT), and calcium ± vitamin D only (CaD), on mortality risk. The study was conducted with community-dwelling elderly (aged 60+ yr) subjects in Dubbo, a semiurban city in Australia. Subjects included 1223 and 819 women and men. There were 325 (BP, n = 106; HT, n = 77; CaD, n = 142) women and 37 men (BP, n = 15; CaD, n = 22) on treatment.

In women, mortality rates were lower with BP 0.8/100 person-years and HT 1.2/100 person-years but not CaD 3.2/100 person-years vs no treatment 3.5/100 person-years . Accounting for age, fracture occurrence, comorbidities, quadriceps strength, and bone mineral density, mortality risk remained lower for women on BP (hazard ratio,HR, 0.3) but not HT (HR 0.8). For 429 women with fractures, mortality risk was still reduced in the BP group (adjusted HR 0.3), not accounted for by a reduction in subsequent fractures. In men, lower mortality rates were observed with BP but not CaD (BP 1.0/100 person-years and CaD 3.1/100 person-years vs no treatment 4.3/100 person- years). After adjustment, mortality was similar, although not significant (HR 0.5).

The researchers concluded: "Osteoporosis therapy appears to reduce mortality risk in women and possibly men."

Talked about for a long time, but "appears" (in the conclusion) is a weak word.

For the full abstract, click here.

The Journal of Clinical Endocrinology & Metabolism published online 2 February 2011
© 2011 by The Endocrine Society
Osteoporosis Medication and Reduced Mortality Risk in Elderly Women and Men. Jacqueline R. Center, Dana Bliuc, Nguyen D. Nguyen, Tuan V. Nguyen and John A. Eisman. Correspondence to Jacqueline Center: j.center@garvan.org.au

Category: M. Musculoskeletal. Keywords: osteoporosis, medication, reduced, mortality, risk, elderly, women, men, prospective cohort study, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 25 February 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.