Bisphosphonates and Mortality in Patients with Osteoporosis: A Real-World Study Using Korean National Health Insurance Service Data

초록

Background/Objective: This study aimed to investigate the association between bisphosphonate (BP) administration and mortality in a real-world setting, focusing on the Korean osteoporosis population, addressing the limited data on Asians in previous research primarily focused on Western populations. Methods: A large retrospective cohort study included female patients aged > 50 years with osteoporosis who were initially received BPs in 2011. Propensity score matched controls were selected from those who had not received BP prescriptions. After propensity score matching, 15,048 participants were included in both the BP group and the control group. Longitudinal data were collected until December 31, 2021. Cox proportional hazard regression analyses were conducted to evaluate the association between BP use and mortality, adjusting for potential confounding variables. Results: The BP group exhibited a significantly lower risk of death compared to the control group (adjusted hazard ratio (HR): 0.89, 95% confidence interval (CI): 0.81–0.98). Subgroup analysis revealed a decreased risk of mortality with 1–3 years of BP use (HR: 0.66, 95% CI: 0.94–0.98), consistent with ≥3 years of BP use (HR: 0.45, 95% CI: 0.35–0.55). Conclusions: BP use is associated with a reduced risk of mortality in osteoporosis patients, with longer-term use showing a further reduction in mortality risk. These findings emphasize the potential benefits of BP in improving survival outcomes among osteoporosis patients and warrant further investigation into the mechanisms underlying this association.