Evidence map›Paper›PMID 25068266›Full record

Observational studyClinical and experimental rheumatology

Fractures and mortality in relation to different osteoporosis treatments.

Huifeng Yun, Elizabeth Delzell, Kenneth G Saag, Meredith L Kilgore, Michael A Morrisey, Paul Muntner, Robert Matthews, Lingli Guo, Nicole Wright, Wilson Smith and 4 more

Open access · greenAbstract readComparative StudyObservational Study
PubMed Full text at PMC
In one paragraph

Observational study in Clinical and experimental rheumatology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Fracture definitions in observational osteoporosis drug effects studies that leverage healthcare administrative (claims) data: a scoping review.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022
    Article
  3. Article
  4. Article
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 2 institutions in 1 country.

Huifeng YunDepartment of Epidemiology, and Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA.
Elizabeth DelzellDepartment of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
Kenneth G SaagDepartment of Epidemiology, and Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA.
Meredith L KilgoreDepartment of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, AL, USA.
Michael A MorriseyDepartment of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, AL, USA.
Paul MuntnerDepartment of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
Robert MatthewsDepartment of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
Lingli GuoDepartment of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
Nicole WrightDepartment of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
Wilson SmithDepartment of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
Cathleen Colón-EmericDuke University Medical Center and the Durham VA GRECC, Durham, NC, USA.
Christopher M O'ConnorDuke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA.
Kenneth W LylesDuke University Medical Center and the Durham VA GRECC, Durham; and The Carolinas Center for Medical Excellence, Cary NC, USA.
Jeffrey R CurtisDepartment of Epidemiology, and Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA.
University of Alabama at Birmingham · USClinical Research Institute · US

Funding

Longitudinal Comparative Effectiveness & Safety of Biologics in AutoimmunityR01HS018517 · AHRQ · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CURTIS, JEFFREY R. · 2009 to 2013
$2.2M
Ethnic Differences in the Risk of Fracture and Vascular DiseaseK23AR053351 · NIAMS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CURTIS, JEFFREY R. · 2007 to 2011
$755k
AHRQ HHS R01 HS018517AHRQ HHS R01HS018517NIAMS NIH HHS AR053351NIAMS NIH HHS K23 AR053351
6 · The paper itself

Abstract

objectivesFew studies have assessed the effectiveness of different drugs for osteoporosis (OP). We aimed to determine if fracture and mortality rates vary among patients initiating different OP medications.

methodsWe used the Medicare 5% sample to identify new users of intravenous (IV) zoledronic acid (n=1.674), oral bisphosphonates (n=32.626), IV ibandronate (n=492), calcitonin (n=2.606), raloxifene (n=1.950), or parathyroid hormone (n=549). We included beneficiaries who were ≥65 years of age, were continuously enrolled in fee-for-service Medicare and initiated therapy during 2007-2009. Outcomes were hip fracture, clinical vertebral fracture, and all-cause mortality, identified using inpatient and physician diagnosis codes for fracture, procedure codes for fracture repair, and vital status information. Cox regression models compared users of each medication to users of IV zoledronic acid, adjusting for multiple confounders.

resultsDuring follow-up (median, 0.8-1.5 years depending on the drug), 787 subjects had hip fractures, 986 had clinical vertebral fractures, and 2.999 died. Positive associations included IV ibandronate with hip fracture (adjusted hazard ratio (HR), 2.37; 95% confidence interval (CI) 1.25-4.51), calcitonin with vertebral fracture (HR=1.59, 95%CI 1.04-2.43), and calcitonin with mortality (HR=1.31; 95%CI 1.02-1.68). Adjusted HRs for other drug-outcome comparisons were not statistically significant.

conclusionsIV ibandronate and calcitonin were associated with higher rates of some types of fracture when compared to IV zolendronic acid. The relatively high mortality associated with use of calcitonin may reflect the poorer health of users of this agent.

Indexed as

AgedAged, 80 and overBone Density Conservation AgentsCause of DeathDatabases, FactualFemaleHip FracturesHumansMaleMedicareOsteoporosisOsteoporotic FracturesRisk FactorsSpinal FracturesTime FactorsTreatment OutcomeBone Density Conservation Agents

Identifiers

PMID25068266
PMCPMC5733785
OpenAlexW2412638644

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.