Predictors of Fracture in Older Women With Osteopenic Hip Bone Mineral Density Treated With Zoledronate.

Show simple item record Reid, Ian R Horne, Anne M Mihov, Borislav Stewart, Angela Bolland, Mark J Bastin, Sonja Gamble, Gregory D 2020-12-08T01:44:17Z 2020-12-08T01:44:17Z 2020-8-24
dc.identifier.issn 0884-0431
dc.description.abstract A recent analysis has found that during treatment with denosumab, women attaining higher bone densities (BMD) are less likely to have incident fractures. We have reexamined this important question using data from our recent trial of zoledronate in osteopenic women. One thousand women randomized to treatment with zoledronate were followed for 6 years. Of those, 122 sustained fragility fractures during follow-up. Baseline age, nonvertebral fracture history, total hip BMD, and calculated fracture risk were all significantly different between those who had fractures during the study and those who did not. BMDs achieved during the study were higher in those without incident fractures. However, achieved BMDs were very closely related to baseline values (r = 0.93, p < 0.0001). The increase in BMD during zoledronate treatment was not different between those who had incident fractures and those who did not (0.15 < p < 0.78), and change in BMD was not predictive of fracture (univariate logistic regression analysis). Stepwise regression analysis of all baseline variables showed the best independent predictors of fracture to be age (odds ratio [OR] = 1.08, 95% confidence interval [CI] 1.04-1.13, p = 0.0003), baseline spine BMD (OR = 0.81, 95% CI 0.67-0.96, p = 0.016), and history of nonvertebral fracture (OR = 1.69, 95% CI 1.06-2.69, p = 0.028). Addition of change in BMD to this model did not improve its predictive power. If changes in BMD were included in the stepwise regression analysis of baseline variables, they did not emerge as significant predictors of fracture. It is concluded that age, fracture history, and baseline BMD determine the risk of new fractures. Differences in achieved BMD between those who do or do not fracture arise from the close relationship between baseline and achieved BMDs. These findings suggest that targeting any particular BMD during treatment is unlikely to be a useful or valid strategy. © 2020 American Society for Bone and Mineral Research (ASBMR).
dc.format.medium Print-Electronic
dc.language eng
dc.publisher Wiley
dc.relation.ispartofseries Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher.
dc.subject Science & Technology
dc.subject Life Sciences & Biomedicine
dc.subject Endocrinology & Metabolism
dc.subject ZOLEDRONATE
dc.subject ALENDRONATE
dc.subject PREVENTION
dc.subject ACID
dc.subject DENOSUMAB
dc.subject FLEX
dc.subject MEN
dc.subject 1103 Clinical Sciences
dc.subject Clinical
dc.subject Clinical Medicine and Science
dc.subject Osteoporosis
dc.subject Injury (total) Accidents/Adverse Effects
dc.subject Aging
dc.subject Musculoskeletal
dc.subject Injuries and Accidents
dc.subject 06 Biological Sciences
dc.subject 09 Engineering
dc.subject 11 Medical and Health Sciences
dc.title Predictors of Fracture in Older Women With Osteopenic Hip Bone Mineral Density Treated With Zoledronate.
dc.type Journal Article
dc.identifier.doi 10.1002/jbmr.4167 2020-11-19T02:10:51Z
dc.rights.holder Copyright: The author en
pubs.publication-status Published
dc.rights.accessrights en
pubs.subtype Journal Article
pubs.elements-id 811019
dc.identifier.eissn 1523-4681
pubs.number jbmr.4167 2020-9-2

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