Anti-osteoporotic medication may reduce secondary fracture risk after compression fracture
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CHICAGO — Although cement augmentation did not alter the rate of secondary fracture after osteoporotic compression fracture, results presented here showed a decrease in secondary fracture rate with anti-osteoporotic medications.
However, researchers found a small percentage of patients received anti-osteoporotic medications.
“Physicians should be aware of this large gap in osteoporosis management, and pathways to increase initiation of anti-osteoporotic medications should be created and implemented,” Emily Mills, MD, said in her presentation at the North American Spine Society Annual Meeting.
Using the PearlDiver Database, Mills and colleagues categorized patients with osteoporotic compression fractures into groups based on whether they underwent cement augmentation or conservative treatment. Researchers further categorized patients in the cement augmentation group based on whether they received anti-osteoporotic medications within 1 year following osteoporotic compression fracture. Researchers used univariate and multivariate regression analyses to identify secondary fracture rate in patients who underwent cement augmentation and received anti-osteoporotic medication.
Results showed 7.3% of patients received anti-osteoporotic medication after initial osteoporotic vertebral compression fracture.
“Looking at all patients who received medications compared to those who did not, on multivariate analysis, this decreased secondary risk by 23%,” Mills said. “Looking at cement augmentation, this did not alter secondary fracture risk on univariate or multivariate analysis.”
Further subdivision based on whether vertebroplasty or kyphoplasty was performed showed neither procedure altered secondary fracture risk on univariate or multivariate analysis, according to Mills. She added patients who received anti-resorptive medications had a decreased secondary fracture risk of 17%.
“We did the same thing with anabolic medications and found that anabolic medications decreased secondary fracture risk by 30% compared to those who did not receive medications at all,” Mills said.
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Mills E, et al. Paper 186. Presented at: North American Spine Society Annual Meeting; Oct. 12-15, 2022; Chicago.
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