{"id":1664,"date":"2022-01-11T00:00:00","date_gmt":"2022-01-11T05:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/comparative-fracture-risk-during-osteoporosis-drug-holidays-after-long-term-risedronate-versus-alendronate-therapy-a-propensity-score-matched-cohort-study\/"},"modified":"2023-06-14T19:57:57","modified_gmt":"2023-06-14T23:57:57","slug":"comparative-fracture-risk-during-osteoporosis-drug-holidays-after-long-term-risedronate-versus-alendronate-therapy-a-propensity-score-matched-cohort-study","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/comparative-fracture-risk-during-osteoporosis-drug-holidays-after-long-term-risedronate-versus-alendronate-therapy-a-propensity-score-matched-cohort-study\/","title":{"rendered":"Comparative fracture risk during osteoporosis drug holidays after long-term risedronate versus alendronate therapy: a propensity score-matched cohort study"},"content":{"rendered":"<p><strong>Background<\/strong> &#x2014; An osteoporosis drug holiday is recommended for most patients after 3 to 5 years of therapy. Risedronate has a shorter half-life than alendronate, and thus the residual length of fracture protection may be shorter.<\/p>\n<p><strong>Objective<\/strong> &#x2014; To examine the comparative risks of drug holidays after long-term (&#x2265;3 years) risedronate versus alendronate therapy.<\/p>\n<p><strong>Design<\/strong> &#x2014; Population-based, matched, cohort study.<\/p>\n<p><strong>Setting<\/strong> &#x2014; Province-wide healthcare administrative databases providing comprehensive coverage to Ontario residents aged 65 years or older between November 2000 and March 2020.<\/p>\n<p><strong>Patients<\/strong> &#x2014; Persons aged 66 years or older who had long-term risedronate therapy and a drug holiday were matched 1:1 on propensity score to those who had long-term alendronate therapy and a drug holiday.<\/p>\n<p><strong>Measurements<\/strong> &#x2014; The primary outcome was hip fracture within 3 years after a 120-day ascertainment period. Secondary analyses included shorter follow-up and sex-specific estimates. Cox proportional hazards models were used to estimate hazard ratios (HRs) for fracture risk between groups.<\/p>\n<p><strong>Results<\/strong> &#x2014; A total of 25 077 propensity score-matched pairs were eligible (mean age, 81 years; 81% women). Hip fracture rates were higher among risedronate than alendronate drug holidays (12.4 and 10.6 events, respectively, per 1000 patient-years; HR, 1.18 [95% CI, 1.04 to 1.34]; 915 total hip fractures). The association was attenuated when any fracture was included as the outcome (HR, 1.07 [CI, 1.00 to 1.16]) and with shorter drug holidays (1 year: HR, 1.03 [CI, 0.85 to 1.24]; 2 years: HR, 1.14 [CI, 0.96 to 1.32]).<\/p>\n<p><strong>Limitation<\/strong> &#x2014; Analyses were limited to healthcare administrative data (potential unmeasured confounding), and some secondary analyses contained few events.<\/p>\n<p><strong>Conclusion<\/strong> &#x2014; Drug holidays after long-term therapy with risedronate were associated with a small increase in risk for hip fracture compared with alendronate drug holidays. Future research should examine how best to mitigate this risk.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background &#x2014; An osteoporosis drug holiday is recommended for most patients after 3 to 5 years of therapy. Risedronate has a shorter half-life than alendronate, and thus the residual length of fracture protection may be shorter. Objective &#x2014; To examine the comparative risks of drug holidays after long-term (&#x2265;3 years) risedronate versus alendronate therapy. Design [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-1664","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Hayes KN, Brown KA, Cheung AM, Kim SA, Juurlink DN, Cadarette SM. <em>Ann Intern Med. <\/em>2022; 175(3):335-43. Epub 2022 Jan 11.","source_url":"https:\/\/doi.org\/10.7326\/M21-2512","ices_scientist":[1204,1181,1282],"site":[6735],"research_program":[6746],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"55692ABD-CAB0-416A-B6CD-B465D53AB895","sitecore_item_name":"Comparative-fracture-risk-during-osteoporosis-drug-holidays-after-long-term-risedronate","sitecore_field_values":"{\n  \"Title\": \"Comparative fracture risk during osteoporosis drug holidays after long-term risedronate versus alendronate therapy: a propensity score-matched cohort study\",\n  \"Short title\": \"Comparative fracture risk during\",\n  \"Summary\": \"The study objective was to examine the comparative risks of drug holidays after long-term (\u22653 years) risedronate versus alendronate therapy.\",\n  \"Citation\": \"<p>Hayes KN, Brown KA, Cheung AM, Kim SA, Juurlink DN, Cadarette SM. <em>Ann Intern Med. <\/em>2022; 175(3):335-43. Epub 2022 Jan 11. DOI: <a href=\"https:\/\/doi.org\/10.7326\/M21-2512\" title=\"opens external link\">https:\/\/doi.org\/10.7326\/M21-2512<\/a><\/p>\",\n  \"Abstract\": \"<p><strong>Background<\/strong> &mdash; An osteoporosis drug holiday is recommended for most patients after 3 to 5 years of therapy. Risedronate has a shorter half-life than alendronate, and thus the residual length of fracture protection may be shorter.<\/p>n<p><strong>Objective<\/strong> &mdash; To examine the comparative risks of drug holidays after long-term (&ge;3 years) risedronate versus alendronate therapy.<\/p>n<p><strong>Design<\/strong> &mdash; Population-based, matched, cohort study.<\/p>n<p><strong>Setting<\/strong> &mdash; Province-wide healthcare administrative databases providing comprehensive coverage to Ontario residents aged 65 years or older between November 2000 and March 2020.<\/p>n<p><strong>Patients<\/strong> &mdash; Persons aged 66 years or older who had long-term risedronate therapy and a drug holiday were matched 1:1 on propensity score to those who had long-term alendronate therapy and a drug holiday.<\/p>n<p><strong>Measurements<\/strong> &mdash; The primary outcome was hip fracture within 3 years after a 120-day ascertainment period. Secondary analyses included shorter follow-up and sex-specific estimates. Cox proportional hazards models were used to estimate hazard ratios (HRs) for fracture risk between groups.<\/p>n<p><strong>Results<\/strong> &mdash; A total of 25 077 propensity score-matched pairs were eligible (mean age, 81 years; 81% women). Hip fracture rates were higher among risedronate than alendronate drug holidays (12.4 and 10.6 events, respectively, per 1000 patient-years; HR, 1.18 [95% CI, 1.04 to 1.34]; 915 total hip fractures). The association was attenuated when any fracture was included as the outcome (HR, 1.07 [CI, 1.00 to 1.16]) and with shorter drug holidays (1 year: HR, 1.03 [CI, 0.85 to 1.24]; 2 years: HR, 1.14 [CI, 0.96 to 1.32]).<\/p>n<p><strong>Limitation<\/strong> &mdash; Analyses were limited to healthcare administrative data (potential unmeasured confounding), and some secondary analyses contained few events.<\/p>n<p><strong>Conclusion<\/strong> &mdash; Drug holidays after long-term therapy with risedronate were associated with a small increase in risk for hip fracture compared with alendronate drug holidays. Future research should examine how best to mitigate this risk.<\/p>\",\n  \"Research Programs\": \"{CFE36C89-C969-4C23-B5E4-1BA9E5BDC273}\",\n  \"ICES Locations\": \"{FBE2D1B1-C0BA-423F-8D16-39466B6C1424}\",\n  \"ICES Scientists\": \"{F399ED3E-29B2-4AF3-A93B-D3444F517985}|{49600D34-E937-4577-AEE0-21FD95500AA4}|{5268F1B0-EB3E-4577-93DF-3C70C9399847}\",\n  \"Posted Date\": \"20220111T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2022\/January\/Comparative-fracture-risk-during-osteoporosis-drug-holidays-after-long-term-risedronate"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Comparative fracture risk during osteoporosis drug holidays after long-term risedronate versus alendronate therapy: a propensity score-matched cohort study<\/title>\n<meta name=\"description\" content=\"Background &#x2014; An osteoporosis drug holiday is recommended for most patients after 3 to 5 years of therapy. 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