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| 題名: | Effects of osteoporosis medications on bone fracture in patients with chronic kidney disease |
| 作者: | 高治圻
Chih Chin Kao, Pei Chen Wu, Ming Tsang Chuang, Shu Ching Yeh, Yen Chung Lin, Hsi Hsien Chen, Te Chao Fang, Wei Chiao Chang, Mai Szu Wu, Tzu Hao Chang |
| 貢獻者: | 醫學系內科學科腎臟內科 |
| 關鍵詞: | Keywords: bone diseases;cardiology;kidney & urinary tract disorders |
| 日期: | 2023-05 |
| 上傳時間: | 2025-03-30 15:39:00 (UTC+8) |
| 摘要: | Abstract
Purpose of the study: The risk of bone fracture is high in patients with chronic kidney disease (CKD), and aggressive treatment to reduce fragility fracture risk is the major strategy. However, the outcomes of osteoporosis medications in patients with CKD remain unclear.
Study design: Patients with stage 3-5 CKD during 2011-2019 were enrolled. Patients were divided into two groups based on receiving osteoporosis medications (bisphosphonates, raloxifene, teriparatide or denosumab) or not. Two groups were matched at a 1:1 ratio by using propensity scores. The outcomes of interest were bone fractures, cardiovascular (CV) events and all-cause mortality. Cox proportional hazard regression models were applied to identify the risk factors. Additional stratified analyses by cumulative dose, treatment length and menopause condition were performed.
Results and conclusions: 67 650 patients were included. After propensity score matching, 1654 patients were included in the study and control group, respectively. The mean age was 70.2?12.4 years, and 32.0% of patients were men. After a mean follow-up of 3.9 years, the incidence rates of bone fracture, CV events and all-cause mortality were 2.0, 1.7 and 6.5 per 1000 person-months, respectively. Multivariate analysis results showed that osteoporosis medications reduced the risk of CV events (HR, 0.35; 95% CI, 0.18 to 0.71; p = 0.004), but did not alleviate the risks of bone fracture (HR, 1.48; 95% CI, 0.73 to 2.98; p = 0.28) and all-cause mortality (HR, 0.93; 95% CI, 0.67 to 1.28; p = 0.65). Stratified analysis showed that bisphosphonates users have most benefits in the reduction of CV events (HR, 0.26; 95% CI, 0.11 to 0.64; p = 0.003). In conclusion, osteoporosis medications did not reduce the risk of bone fractures, or mortality, but improved CV outcomes in patients with CKD. |
| 關聯: | Postgrad Med J. 2023 May 22 ; 99 (1170) : 340-349 |
| 描述: | 【111-2 升等】臺北醫學大學教師升等專門著作
職別：專任教師
送審等級：副教授
著作送審 |
| 資料類型: | article |
| 顯示於類別: | [教師升等送審著作] 111
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