J INTERN MED:髋部骨折患者停用抗骨质疏松药物后骨折风险增加

2021-07-10 MedSci原创 MedSci原创

停用狄诺塞麦会导致骨质疏松性骨折的风险增加,尤其是椎体骨折,增加的风险往往会在停药后一年内显现出来。

近日,内科学领域权威杂志Journal of Internal Medicine上发表一篇研究文章,该研究旨在比较停用抗骨质疏松药物治疗的患者发生严重骨质疏松、椎体和非椎体骨折的风险。

研究人员进行了一项基于全国人群的队列研究设计的有效性比较研究。该研究纳入了2012年至2015年间因髋部骨折事件入院并接受狄诺塞麦或双膦酸盐治疗且依从性达一年以上的50岁以上患者。

根据患者随后的用药模式,将患者分为持续性或非持续性狄诺塞麦或双膦酸盐使用者。该研究的主要结局是随后因严重骨质疏松、椎体或非椎体骨折而住院。研究人员使用多变量、时变Cox比例风险模型评估主要结局的风险。

与持续使用狄诺塞麦者相比,非持续性狄诺塞麦使用者发生严重骨质疏松性骨折(风险比(HR)=1.60;95%置信区间(CI)为1.20至2.14)、椎骨骨折(HR=2.18;95%CI为1.46至3.24)和死亡(HR=3.57;95%CI为2.63至4.84)的风险显著提高。然而,在持续性和非持续性双膦酸盐使用者中均未发现骨折风险增加。值得注意的是,非持续使用狄诺塞麦的患者在停药后一年内(HR=2.90,95%CI为1.77至4.74)和停用狄诺塞麦治疗2年(HR=3.58;95%CI为1.74至7.40)椎体骨折风险显著增加。

由此可见,停用狄诺塞麦会导致骨质疏松性骨折的风险增加,尤其是椎体骨折,增加的风险往往会在停药后一年内显现出来。

原始出处:

Shau-Huai Fu.et al.Increased fracture risk after discontinuation of anti-osteoporosis medications among hip fracture patients: a population-based cohort study.J INTERN MED.2021.https://doi.org/10.1111/joim.13354

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    2021-07-12 liuquan
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    2021-07-12 Eleven17
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