Timing of Bisphosphonate (Alendronate) Initiation after Surgery for Fragility Fracture: A Population-Based Cohort Study

Wu, Meng-Huang; Lin, Yu‐Sheng; Wu, Chih‐Hsiung; Lee, Ching‐Yu; Chen, Yi‐Chia; Huang, Tsung-Jen; Cheng, Jur–Shan

doi:10.3390/jcm10122541

Cited by 4 publications

(4 citation statements)

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“…Вот почему крайне важно как можно скорее выявить пациентов, получивших перелом, в СППП, начать лечение остеопороза и инициировать мероприятия по снижению риска падений. Так, в ретроспективном популяционном когортном исследовании у пациентов, начавших прием пероральных бисфосфонатов (БФ) в срок до 3 мес после «индексного» перелома, по сравнению с теми, у кого лечение началось более чем через 3 мес, было отмечено снижение частоты второго низкоэнергетического перелома (SHR=0,509; 95% ДИ 0,352-0,735) и повторной операции по поводу него (SHR=0,452; 95% ДИ 0,268-0,763) [10].…”

Section: критерии качества длительного наблюдения пациентовunclassified

Long-term follow-up of patients in fracture liaison services: problems and solutions (literature review and own data)

2023

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To reduce the frequency of fragility fractures, Fracture Liaison Services are being created worldwide. One of the most difficult parts in their organization is considered to be the creation of an effective system of long-term patient management. Many factors are involved in this process, concerning the patient, the team of specialist, the peculiarities of the organization of primary health care, and many others. On the one hand, it has been shown that the inclusion of patients in FLS increases their commitment to the implementation of doctor’s recommendations. On the other hand, there are a number of barriers depending both on the characteristics of the patient himself (polymorbidity, severity of the condition, decreased cognitive function, fear of side effects, low motivation to treat osteoporosis) and on various aspects in the medical care organization. The article analyzes the importance of training patients and medical personnel, approaches to the choice of therapeutic tactics, optimization of the process of succession management of patients, the availability of a system of information exchange between medical institutions. Using the example of the Yaroslavl’ FLS, the possibilities of improving various aspects of medical care are analyzed, as well as local problems that arose at various stages of the development of this service, and the measures that were applied to resolve them.

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Section: критерии качества длительного наблюдения пациентовunclassified

Long-term follow-up of patients in fracture liaison services: problems and solutions (literature review and own data)

2023

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“…Moreover, early initiation of ZA has its own additional advantages in improving overall bone health, decreasing the risk of subsequent fracture, and reducing the mortality rate. In a retrospective cohort study from Taiwan, 43 patients were divided into early initiation of bisphosphonates (EIBP) and late initiation of bisphosphonates (LIBP) groups, depending upon the timing of initiation of weekly alendronate (70 mg) therapy. In the EIBP group, alendronate was started within 3 months of the first fragility fracture, while on the contrary, it was started after 3 months in the LIBP group.…”

Section: Effect Of Timing Of Therapy On Fracture Healingmentioning

confidence: 99%

Timing of osteoporosis therapies following fracture: the current status

Palui

Durgia

Sahoo

et al. 2022

Therapeutic Advances in Endocrinology

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In most patients, osteoporosis is diagnosed only after the occurrence of the first fragility fracture. It is of utmost importance to start osteoporosis medications immediately in these patients to prevent future fractures and also to reduce associated mortality and morbidity. There remains a hesitancy over initiating osteoporotic medications, specifically for antiresorptive agents like bisphosphonates following an acute fracture due to concern over their effect on fracture healing. The purpose of this review is to study the effect of the timing of initiation of different osteoporosis medications on healing after an acute fracture. Most of the human studies, including randomized control trials (RCTs), did not find any significant negative effect on fracture healing with early use of bisphosphonate after an acute fracture. Anabolic agents like teriparatide have shown either neutral or beneficial effects on fracture healing and thus can be started very early following any osteoporotic fracture. Although human studies on the early use of other osteoporosis medications like denosumab or strontium ranelate are very sparse in the literature, none of these medications have shown any evidence of delay in fracture healing. To summarize, among the commonly used anti-osteoporosis agents, both bisphosphonates and teriparatide are safe to be initiated in the early acute post-fracture period. Moreover, teriparatide has shown some evidence in favor of reducing fracture healing time.

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“…The ubiquitous occurrence of disease-related secondary changes in bone metabolism implies that numerous medical disciplines need to interact. Especially if surgical interventions and surgical fracture repair are necessary, initiation of specific osteoporosis medication such as bisphosphonates can avoid refractures after surgery [ 12 , 13 ].…”

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confidence: 99%