Secular Trends in Long-Term Oral Bisphosphonate Use

Excerpt

Bisphosphonates (BP) have been used for over 20 years to treat osteoporosis, based on strong evidence of fracture risk reduction in high-risk women treated up to 5 years.¹ Although discontinuation rates are high in the first year, greater treatment adherence is associated with increased fracture risk reduction. However, the optimal duration of BP therapy remains unclear. Since 2008, national declines in the number of patients receiving BP therapy have been observed,^2,3 with total dispensed BP prescriptions falling from 31 to 14 million between 2008 and 2012.³ A confluence of factors may account for this, including concerns for rare adverse side effects² and revised national practice guidelines reducing treatment of low-risk women^4,5; these same factors may have prompted patients taking BP and providers prescribing BP to interrupt treatment. This report examines secular trends in long-term BP continuation and examines whether late non-adherence is more prominent in the years following new practice guidelines and news of potential harms from extended use. …