AIM. The Biphosphonates Efficacy-Safety Tradeoff (BEST) study was designed to evaluate efficacy and safety of oral BP in primary care. METHODS. Hospital discharges and pharmacy claims, collected over a population of 19 million enrolees in the Italian National Health System, were used to select records of subjects aged 55+ years, discharged from hospital with a primary diagnosis of fracture at osteoporotic sites. Exclusion criteria included cancer, Paget disease, and previous BP use. Post-discharge prescription of oral BP was recorded. Outcomes of the BEST study are: 1) occurrence of osteonecrosis of the jaw (ONJ), 2) gastro-intestinal bleeding, and 3) recurrent fracture. Data on BP utilization and ICD9CM-based diagnoses of ONJ are currently available. RESULTS. Out of 72,675 eligible subjects (mean age: 67 years; 71% females), 11% (females: 16%, males: 6%; p<0.001) received at least one BP prescription in the follow-up. Peak prescription rate (26% in females and 19% in males) was reached at age 70-74 years and declined sharply thereafter, being below 7% after the age of 85 in both sexes (age trend: p<0.001). Based upon selected ICD9CM codes, 135 cases of possible and 162 of probable ONJ were identified; the corresponding incidence densities were 0.15 and 0.22 per 10,000 person-years, respectively. Association with BF use will be evaluated after adjudication of final diagnoses by an expert panel. CONCLUSIONS. In this large sample of Italian population with such a compelling indication as an osteoporotic fracture, BP are substantially underprescribed, especially in oldest subjects.

Di Bari, M., Lapi, F., Corrao, G., Sturkenboom, M., Carle, F., Montanaro, N., et al. (2010). USE OF BIPHOSPHONATES AFTER OSTEOPOROTIC FRACTURES: THE BIPHOSPHONATES EFFICACY-SAFETY TRADEOFF (BEST) STUDY. Intervento presentato a: The Gerontological Society of America 63rd Annual Scientific Meeting - November 19–23, 2010, New Orleans, LA, USA.

USE OF BIPHOSPHONATES AFTER OSTEOPOROTIC FRACTURES: THE BIPHOSPHONATES EFFICACY-SAFETY TRADEOFF (BEST) STUDY

Mazzaglia G
2010

Abstract

AIM. The Biphosphonates Efficacy-Safety Tradeoff (BEST) study was designed to evaluate efficacy and safety of oral BP in primary care. METHODS. Hospital discharges and pharmacy claims, collected over a population of 19 million enrolees in the Italian National Health System, were used to select records of subjects aged 55+ years, discharged from hospital with a primary diagnosis of fracture at osteoporotic sites. Exclusion criteria included cancer, Paget disease, and previous BP use. Post-discharge prescription of oral BP was recorded. Outcomes of the BEST study are: 1) occurrence of osteonecrosis of the jaw (ONJ), 2) gastro-intestinal bleeding, and 3) recurrent fracture. Data on BP utilization and ICD9CM-based diagnoses of ONJ are currently available. RESULTS. Out of 72,675 eligible subjects (mean age: 67 years; 71% females), 11% (females: 16%, males: 6%; p<0.001) received at least one BP prescription in the follow-up. Peak prescription rate (26% in females and 19% in males) was reached at age 70-74 years and declined sharply thereafter, being below 7% after the age of 85 in both sexes (age trend: p<0.001). Based upon selected ICD9CM codes, 135 cases of possible and 162 of probable ONJ were identified; the corresponding incidence densities were 0.15 and 0.22 per 10,000 person-years, respectively. Association with BF use will be evaluated after adjudication of final diagnoses by an expert panel. CONCLUSIONS. In this large sample of Italian population with such a compelling indication as an osteoporotic fracture, BP are substantially underprescribed, especially in oldest subjects.
Si
abstract
Biphosphonates, safety, ONJ, fractures, electronic healthcare database, cohort;
English
The Gerontological Society of America 63rd Annual Scientific Meeting - November 19–23, 2010
Di Bari, M., Lapi, F., Corrao, G., Sturkenboom, M., Carle, F., Montanaro, N., et al. (2010). USE OF BIPHOSPHONATES AFTER OSTEOPOROTIC FRACTURES: THE BIPHOSPHONATES EFFICACY-SAFETY TRADEOFF (BEST) STUDY. Intervento presentato a: The Gerontological Society of America 63rd Annual Scientific Meeting - November 19–23, 2010, New Orleans, LA, USA.
Di Bari, M; Lapi, F; Corrao, G; Sturkenboom, M; Carle, F; Montanaro, N; Caputi, A; Mazzaglia, G
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/387085
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