Hip fractures prevention: Effectiveness with alendronate plus calcium+vitamin D compared with calcium +vitamin (control group)
DOI:
https://doi.org/10.51481/amc.v58i4.939Keywords:
alendronate, osteoporosis, hip fracture, calcium, cholecalciferol, D3 vitaminAbstract
Objective: To establish the effectiveness of alendronate, compared to a control group, in preventing hip fracture and outline the short-term mortality.
Methods: Observational, analytical study, with all patients treated at the Social Security, for at least 1 continuous year, with alendronate, calcium and vitamin D (group A) and control group (C) with calcium and vitamin D, follow up by three years or until the event occurred (hip fracture) according to the institutional record for diagnosis and discharge status (alive or deceased). Subgroup analyzes> 65 years.
Results: The total sample included 10395 patients that followed the pretreatment and the 3-year follow up. Group A n = 5.570 (53.58%) exposed to weekly 70mg alendronate with calcium and vitamin D, 95% female, mean age 69 years, median treatment period before event 749 days. Control group C n = 4.825, that received calcium and vitamin D, 89% female, 66 years old and 775 days of treatment, respectively. During the studied period (three years) 108 fractures were registered, 60 in group A (1.08%) and 48 in group C (0.99%). The effectiveness of the treatment with alendronate (with calcium and vitamin D) to prevent hip fracture was established in the 98.92%, similar to that registered for the control group (99.01). The acute mortality for hip fracture, registered in a maximum time of 35 days of hospitalization (table 2), in the alendronate group reached the 11.66% and were all women. In the control group acute mortality reached 22.91% and 72.72% were women.
Conclusions: Alendronate showed similar effectiveness to control to prevent hip fractures. Older adults were more vulnerable to suffer this event and a short-term fatal outcome.
Downloads
References
National Institute for Health and Care Excellence. Osteoporosis: assessing the risk of fragility fracture. Issued: August 2012. NICE clinical guideline 146. Hallado en https://www.nice.org.uk/guidance/cg146/chapter/introduction. Acceso el 09-06-2015.
Rosen HN, Drezner MK: UpToDate® Overview of the management of osteoporosis in postmenopausal women. Apr 17, 2015. Hallado en http:// www.uptodate.com.ezproxy.sibdi.ucr.ac.cr:2048/contents/overview-ofthe-management-of-osteoporosis-in-postmenopausal-women?source=mac hineLearning&search=osteoporosis+tratamiento&selectedTitle=1~150&s ectionRank=1&anchor=H8#H8. Acceso el 10-08-2015.
Wells GA, Cranney A, Peterson J, Boucher M, Shea B, Welch V, et al. Alendronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women. Cochrane Database of Systematic Reviews. Issue 7, 2015. Art. No. CD001155. DOI: 10.1002/14651858. CD001155.pub1. Hallado en http://cochrane.bvsalud.org/doc. php?db=reviews&id=CD001155. Acceso el 17-08-2015.
Freemantle N, Cooper C, Diez-Pérez A, Gitlin M, Radclife H, Sheperd S, Roux C. Results of indirect and mixed treatment comparison of fracture efficacy for osteoporosis treatments: a meta-analysis. Osteoporos Int 2013; 24: 209-217.
Crandall CJ, Newberry SJ, Gellad WG, Diamant A, Lim YW, Suttorp M, et al. Treatment to Prevent Fractures in Men and Women with Low Bone Density or Osteoporosis: Update of a 2007 Report. Comparative Effectiveness Review No. 53. (Prepared by Southern California Evidence-based Practice Center under Contract No. HHSA-290-2007-10062-I.) Rockville, MD: Agency for Healthcare Research and Quality; March 2012. Report No.: 12-EHC023-EF. Hallado en http://www.ncbi.nlm.nih.gov/books/NBK92566/. Acceso el 0806-2015.
Crandall CJ, Newberry SJ, Diamant A, Lim YW, Gellad WF, Booth MJ, et al. Comparative effectiveness of pharmacological treatments to prevent fractures. Ann Intern Med 2014, 161: 711-723.
MacLean C, Newbewrry S, Maglione M, McMahon M, Ranganath V, Suttorp M, et al. Systematic Review: comparative effectiveness of treatments to prevent fractures in men and women con los bone density or osteoporosis. Ann Intern Med 2008, 148: 197-213.
Avenell A, Mak JCS, O'Connell D. Vitamin D and vitamin D analogues for preventing fractures in post-menopausal women and older men. Cochrane Database of Systematic Reviews 2014, Issue 4. Art. No.: CD000227. DOI:
1002/14651858.CD000227.pub4. Hallado en http://onlinelibrary.wiley.
com/doi/10.1002/14651858.CD000227.pub4/full. Acceso el 09-06-2015.
Homik J, Suarez-Almazor ME, Shea B, Cranney A, Wells GA, Tugwell P. Calcium and vitamin D for corticosteroid-induced osteoporosis. Cochrane Database of Systematic Reviews 1998, Issue 2. Art. No.: CD000952. DOI: 10.1002/14651858.CD000952. Hallado en http://onlinelibrary.wiley.com/ doi/10.1002/14651858.CD000952/full. Acceso el 09-06-2015.
Sancho Rojas CA, Arguedas Chaverri C. Epidemiología de la fractura de cadera de origen osteoporótico en Costa Rica en un periodo de cinco años. REEMO, 2000, 9 (2, marzo-abril): 66-69.
López G, Chacón K, Rivera A. Incidencia de fractura de cadera en Costa Rica. Revista Médica de Costa Rica y Centroamérica 2007, LXIV. 125-132.
Ley Reguladora de Investigación Biomédica. La Gaceta Nº 79 — Viernes 25 de abril de 2014
Decreto Nº 39061-S Reglamento a la Ley Reguladora de Investigación Biomédica. La Gaceta N° 138 - Viernes 17 de julio de 2015
Dynamed® Bisphosphonates for treatment and prevention of osteoporosis. Updated 2015 Jul 13 09:10:00 AM. Hallado en http://web.b.ebscohost.com. ezproxy.sibdi.ucr.ac.cr:2048/dynamed/detail?sid=d9533206-cc73-454ead7a-efce27e28304%40sessionmgr110&vid=1&hid=109&bdata=Jmxhbmc9 ZXMmc2l0ZT1keW5hbWVkLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#AN=9-
&db=dme. Acceso el 21-08-2015.
Florence R, Allen S, Benedict L, Compo R, Jensen A, Kalogeropoulou D, et al. Diagnosis and treatment of osteoporosis. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2013 Jul. 87 p. http://www.guideline. gov/content.aspx?id=47543&search=biphosphonates. Acceso el 21-04-2015.
American College of Obstetricians and Gynecologists (ACOG). Osteoporosis. Washington (DC): American College of Obstetricians and Gynecologists (ACOG); 2012 Sep. 17 p. (ACOG practice bulletin; no. 129). http://www. guideline.gov/content.aspx?id=38413&search=biphosphonates. Acceso el 2104-2015.
Michigan Quality Improvement Consortium. Management and prevention of osteoporosis. Southfield (MI): Michigan Quality Improvement Consortium; 2014 Jan. http://www.guideline.gov/content.aspx?id=47804&search=bipho sphonates, 21-04-2015.
Cosman F, de Beur SJ, LeBoff MS, Lewiecki EM, Tanner B, Randall S, et al. Clinician's Guide to Prevention and Treatment of Osteoporosis. National Osteoporosis Foundation. Osteoporos Int. 2014; 25: 2359-81.
Kendrick D, Kumar A, Carpenter H, Zijlstra GAR, Skelton DA, Cook JR, et al. Exercise for reducing fear of falling in older people living in the community. Cochrane Database of Systematic Reviews 2014, Issue 11. Art. No.: CD009848. DOI: 10.1002/14651858.CD009848.pub2. Hallado en http:// onlinelibrary.wiley.com/doi/10.1002/14651858.CD009848.pub2/full. Acceso el 09-06-2015.
Hopewell S, Adedire O, Copsey BJ, Sherrington C, Clemson LM, Close JCT, et al. Multifactorial and multiple component interventions for preventing falls in older people living in the community (Protocol). Cochrane Database of Systematic Reviews 2016, Issue 6. Art. No.: CD012221. DOI: 10.1002/14651858.CD012221. Hallado en http://onlinelibrary.wiley.com/ doi/10.1002/14651858.CD012221/full. Acceso el 09-08-2016.
Medical Advisory Secretariat. Prevention of falls and fall-related injuries in community-dwelling seniors: an evidence-based analysis. Ontario Health Technology Assessment Series 2008; 8. Hallado en http://www.ncbi.nlm. nih.gov/pmc/articles/PMC3377567/pdf/ohtas-08-78.pdf. Acceso el 21-082015.
Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, et al. Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews 2012, Issue 9. Art. No.: CD007146. DOI: 10.1002/14651858.CD007146.pub3. Hallado en http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007146.pub3/ epdf. Acceso el 12-08-2015.
Winter H1, Watt K, Peel NM. Falls prevention interventions for communitydwelling older persons with cognitive impairment: a systematic review. Int Psychogeriatr 2013; 25: 215-27.
Mechanick JI, Harrell RM, Allende-Vigo MZ, Alvayero C, Arita-Melzer O, Aschner P, et al. Transculturalization Recommendations For Developing Latin American Clinical Practice Algorithms In Endocrinology--Proceedings Of The 2015 Pan-American Workshop By The American Association Of Clinical Endocrinologists and American College Of Endocrinology. Endocr Pract. 2016; 22: 476-501.
Downloads
Published
Versions
- 2016-11-10 (2)
- 2016-11-10 (1)
Issue
Section
License
Copyright (c) 2016 Acta Médica Costarricense
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Los autores que publican en la revista Acta Médica Costarricense pueden distribuir, copiar, remezclar, retocar, leer, descargar, imprimir, buscar y crear a partir de su obra de modo no comercial, indicando los créditos a la revista y sus autores y compartir su obra en las mismas condiciones. Para ello se aplica la licencia Creative Commons Reconocimiento-NoComercial-CompartirIgual 4.0 Internacional(CC BY-NC-SA 4.0)
