Fractures in women treated with raloxifene or alendronate: a retrospective database analysis

BMC Women's Health

Research Article

Shonda A Foster¹  John Stock¹  Russel Burge¹  John H Krege²  Suellen Curkendall³  Bong-Chul Chu³  Nianwen Shi³  David R Diakun³ 

[1] Eli Lilly and Company, Indianapolis, IN, USA;Lilly USA, LLC, Indianapolis, IN, USA;Truven Health Analytics, Bethesda, MD, USA;

关键词: Vertebral fracture;    Nonvertebral fracture;    Breast cancer;    Alendronate;    Raloxifene;   

DOI  :  10.1186/1472-6874-13-15

 received in 2012-09-12, accepted in 2013-03-18,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundRaloxifene and alendronate are anti-resorptive therapies approved for the prevention and treatment of postmenopausal osteoporosis. Raloxifene is also indicated to reduce the risk of invasive breast cancer in postmenopausal women with osteoporosis and in postmenopausal women at high risk of invasive breast cancer. A definitive study comparing the fracture effectiveness and rate of breast cancer for raloxifene and alendronate has not been published. The purpose of this retrospective cohort study was to evaluate fracture and breast cancer rates among patients treated with raloxifene or alendronate.MethodsFemales ≥45 years who initiated raloxifene or alendronate in 1998–2006 Truven Health Analytics MarketScan® Databases, had continuous enrollment 12 months prior to and at least 12 months after the index date, and had a treatment medication possession ratio ≥80% were included in this study. Rates of vertebral and nonvertebral fractures and breast cancer during 1, 3, 5, 6, 7, and 8 years of treatment with raloxifene or alendronate were evaluated. Fracture rates were adjusted for potential treatment bias using inverse probability of treatment weights. Multivariate hazard ratios were estimated for vertebral and nonvertebral fractures.ResultsRaloxifene patients had statistically significantly lower rates of vertebral fractures in 1, 3, 5, and 7 years and for nonvertebral fractures in 1 and 5 years. There were no statistically significant differences in the adjusted fracture rates between raloxifene and alendronate cohorts, except in the 3-year nonvertebral fracture rates where raloxifene was higher. Multivariate hazard ratios of raloxifene versus alendronate cohorts were not significantly different for vertebral and nonvertebral fracture in 1, 3, 5, 6, 7, and 8 years. Unweighted and weighted breast cancer rates were lower among raloxifene recipients.ConclusionsPatients treated with alendronate and raloxifene had similar adjusted fracture rates in up to 8 years of adherent treatment, and raloxifene patients had lower breast cancer rates.

【 授权许可】

CC BY   
© Foster et al.; licensee BioMed Central Ltd. 2013