Life expectancy in patients treated for osteoporosis: observational cohort study using national Danish prescription data
Life expectancy in patients treated for osteoporosis: observational cohort study using national Danish prescription data
Osteoporosis is a chronic disease, carrying an elevated risk of fractures, morbidity and death. Long term treatment may be required but the long term risks with osteoporosis drugs remain incompletely understood. The competing risk of death may be a barrier to treating the oldest, yet this may not be rational if the risk of death is reduced by treatment. It is difficult to devise goal directed long term strategies for managing osteoporosis without firm information about residual lifetime expectancy in treated patients. We conducted an observational study in Danish national registries tracking prescriptions for osteoporosis drugs, comorbid conditions and deaths. We included 58,637 patients and 225,084 age- and gender matched control subjects. Information on deaths until the end of 2013 was retrieved, providing a follow-up period of 10–17 years.
In men below age 80 and women below age 60, the relative risk of dying declined from being strongly increased in the first year to a stable but elevated level in subsequent years. In women older than 65–70 years of age there was only a small elevation in risk in the first year of treatment followed by lower than background mortality. The residual life expectancy of a 50-year old man beginning osteoporosis treatment was estimated to be 18.2 years and 7.5 years in a 75-year old man. Estimates in women were 26.4 years and 13.5 years.
This study shows an excess mortality in men and in women below age 70 who are treated for osteoporosis, compared with the background population. This excess risk is more pronounced in the first few years on treatment. The average life expectancy of osteoporosis patients is in excess of fifteen years in women below the age of 75 and in men below the age of 60, highlighting the importance of developing tools for long term management.
epidemiology, osteoporosis, mortality, drug treatment, public health
1553-1559
Abrahamsen, B.
fee8b1eb-c267-4d2a-952a-d1b9f20d0125
Osmond, C.
2677bf85-494f-4a78-adf8-580e1b8acb81
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Abrahamsen, B.
fee8b1eb-c267-4d2a-952a-d1b9f20d0125
Osmond, C.
2677bf85-494f-4a78-adf8-580e1b8acb81
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Abrahamsen, B., Osmond, C. and Cooper, C.
(2015)
Life expectancy in patients treated for osteoporosis: observational cohort study using national Danish prescription data.
Journal of Bone and Mineral Research, 30 (9), .
(doi:10.1002/jbmr.2478).
(PMID:25663501)
Abstract
Osteoporosis is a chronic disease, carrying an elevated risk of fractures, morbidity and death. Long term treatment may be required but the long term risks with osteoporosis drugs remain incompletely understood. The competing risk of death may be a barrier to treating the oldest, yet this may not be rational if the risk of death is reduced by treatment. It is difficult to devise goal directed long term strategies for managing osteoporosis without firm information about residual lifetime expectancy in treated patients. We conducted an observational study in Danish national registries tracking prescriptions for osteoporosis drugs, comorbid conditions and deaths. We included 58,637 patients and 225,084 age- and gender matched control subjects. Information on deaths until the end of 2013 was retrieved, providing a follow-up period of 10–17 years.
In men below age 80 and women below age 60, the relative risk of dying declined from being strongly increased in the first year to a stable but elevated level in subsequent years. In women older than 65–70 years of age there was only a small elevation in risk in the first year of treatment followed by lower than background mortality. The residual life expectancy of a 50-year old man beginning osteoporosis treatment was estimated to be 18.2 years and 7.5 years in a 75-year old man. Estimates in women were 26.4 years and 13.5 years.
This study shows an excess mortality in men and in women below age 70 who are treated for osteoporosis, compared with the background population. This excess risk is more pronounced in the first few years on treatment. The average life expectancy of osteoporosis patients is in excess of fifteen years in women below the age of 75 and in men below the age of 60, highlighting the importance of developing tools for long term management.
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Submitted date: 7 February 2015
e-pub ahead of print date: 7 February 2015
Keywords:
epidemiology, osteoporosis, mortality, drug treatment, public health
Organisations:
Human Development & Health
Identifiers
Local EPrints ID: 375809
URI: http://eprints.soton.ac.uk/id/eprint/375809
ISSN: 0884-0431
PURE UUID: 38f132ea-7ff7-4dcf-bc22-d35bafba9ec0
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Date deposited: 15 Apr 2015 14:26
Last modified: 18 Mar 2024 02:45
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Author:
B. Abrahamsen
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