Can Treatment Influence Osteoporotic Fracture Risk?

What are the risk factors for osteoporotic fractures in patients on alendronate treatment? In a study, a team led by researchers at the University of Southern Denmark’s Institute of Clinical Research set out to explore the characteristics that may cause patients taking alendronate to experience fractures.
A team set out to explore the characteristics that may cause patients taking alendronate to experience fractures.The study, “Characteristics of patients who suffer major osteoporotic fractures despite adhering to alendronate treatment: a National Prescription registry study,” was published online ahead of print in October 2012. It appears in Osteoporosis International. The researchers were interested in whether patients who are adherent to alendronate treatment have different risk factors for osteoporotic fractures than the general population.

The study authors relied on data from the Danish National Prescription registry. More than 38,000 new users of alendronate were identified and included in the study. The researchers collected data on the prevalence of osteoporotic fractures 6 or more months after the first prescription was filled.

The study results showed that 5.5% (1,072) of the final patient sample sustained major osteoporotic fractures during the study period. The risk of fracture was greater in men and older adults. Additionally, taking other medications, history of prior fractures, dementia, and ulcer disease were additional fracture risk factors.

The results did not find that diabetes or rheumatic disorders were risk factors in the studied population. Additionally, patients using glucocorticoids had a lowered risk for osteoporotic fractures.
The study authors conclude that their findings demonstrate differences in risk factors for patients on alendronate compared to the general population. They argue that ulcer disease and dementia in these patients may affect their ability to properly adhere to their medication regimens.

The researchers note that their results do not prove causal relationships between fracture risk and the identified risk factors, but state that it may be useful to examine dementia, ulcer disease, and Parkinson’s disease as risk factors for alendronate treatment adherent patients.