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Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa, 08 Jan 2021
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Fracture-prevention benefits of anti-osteoporosis medications rely on timing

23 Aug 2020

Timely initiation of anti-osteoporosis medications (AOMs), between 15 and 84 days after an index fracture, is crucial to obtaining their preventive benefit for subsequent fractures, a study has found.

Researchers looked at 77,930 individuals aged ≥50 years who had been hospitalized for hip fracture, among whom 9,986 were prescribed AOMs, including bisphosphonates, calcitonin, raloxifene, and denosumab, less than a year after being diagnosed with hip fracture.

AOM users were grouped according to the timing of medication initiation: ≤14 days (very early; n=1,826), 15–84 days (early; n=6,005); 85–252 days (late; n=1,746), and 253–365 days (very late; n=409). Early users were significantly older relative to other groups. Most very late users took AOMs concurrently with other medications. The very early group had the shortest length of hospital stay.

In multivariate Cox proportional hazards models, very late initiation of AOMs was associated with about a twofold higher risk of fracture-related hospitalization compared with early initiation (hazard ratio [HR], 1.93, 95 percent confidence interval [CI], 1.29–2.89).

The main AOMs used in this study was alendronate (68.74 percent), and the results of individual component of AOMs were similar with the overall cohort. Furthermore, both sensitivity and prespecified subgroup analyses yielded similar results.

The risk increase observed with very late AOM initiation was especially pronounced among patients with high medication adherence (HR, 2.56, 95 percent CI, 1.41–4.64).

The findings indicate that in addition to good adherence, early initiation of AOMs is important to effectively reduce the risk of subsequent fractures, the researchers said. They believe that the study contributes to current knowledge about the optimal time to initiate AOMs which can, in turn, be used to refine clinical practice.

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Most Read Articles
01 Dec 2020
Tetanus toxoid 5 Lf, diphtheria toxoid 2 Lf, pertussis toxoid 2.5 mcg, filamentous haemagglutinin 5 mcg, fimbriae types 2 and 3 5 mcg, pertactin 3 mcg
Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa, 08 Jan 2021
Antimicrobial resistance has become increasingly dire as the rapid emergence of drug resistance, especially gram-negative pathogens, has outpaced the development of new antibiotics. At a recent virtual symposium, Dr Hsu Li Yang, Vice Dean (Global Health) and Programme Leader (Infectious Diseases), NUS Saw Swee Hock School of Public Health, presented epidemiological data on multidrug-resistant (MDR) gram-negative bacteria (GNB) in Asia, while Dr Tan Thuan Tong, Head and Senior Consultant, Department of Infectious Diseases, Singapore General Hospital (SGH), focused on the role of ceftazidime-avibactam in MDR GNB infections. Dr Andrea Kwa, Assistant Director of Research, Department of Pharmacy, SGH, joined the panel in an interactive fireside chat, to discuss challenges, practical considerations, and solutions in MDR gram-negative infections. This Pfizer-sponsored symposium was chaired by Dr Ng Shin Yi, Head and Senior Consultant of Surgical Intensive Care, SGH.
Jairia Dela Cruz, 3 days ago
Spending too much time sitting cannot be good for the body, and rising to one's feet breaks up such a behaviour and yields small, but meaningful, reductions in certain cardiovascular disease (CVD) risk factors, according to the results of a meta-analysis.
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Use of thyroid hormone therapy does not seem to protect older adults with subclinical hypothyroidism against mortality, but it appears to confer survival benefits to those aged <65 years, results of a study have shown.