Adams AL, et al. - In this retrospective cohort study, the researchers compared the incidence of osteoporosis-related fractures among women who had a bisphosphonate (BP) holiday to those who continued to use BPs. It was concluded that BP holiday remained a viable strategy for balancing the benefits and potential harms linked with long-term BP use.

Methods

• This investiagtion was conducted within four Kaiser Permanente integrated health system regions.
• Study participants were 39,502 women aged ≥45 years with ≥3 years exposure to BP.
• For this analysis, participants with a BP holiday (≥12 months with no use) were compared to persistent (use with ≥50% adherence) and nonpersistent (use with <50% adherence) users for incident osteoporosis-related fractures.

Results

• According to the findings obtained, the BP holiday (n = 11,497), nonpersistent user (n = 10,882), and persistent user groups (n = 17,123) were observed for 156,657 person-years.
• An aggregate of 5199 osteoporosis-related fractures (involving 1515 hip fractures and 2147 vertebral fractures) were observed.
• There was a slight difference in overall osteoporosis-related fracture risk (HR 0.92; 95% CI, 0.84 to 0.99) and no difference in hip fracture risk (HR 0.95; 95% CI, 0.83 to 1.10) for the BP holiday group compared to the persistent use group.
• A slight reduction in risk of vertebral fracture was noted (HR 0.83; 95% CI, 0.74 to 0.95).
• The BP holiday group was at decreased risk for osteoporosis-related fractures (HR 0.71; 95% CI, 0.65 to 0.79), vertebral fractures (HR 0.68; 95% CI, 0.59 to 0.78), and hip fractures (HR 0.59; 95% CI, 0.50 to 0.70) compared to the nonpersistent user group.
• The study findings suggested that women who undertake a BP holiday from BP of ≥12 months duration for any reason after ≥3 years of BP use do not appear to be at greater risk of osteoporosis-related fragility fracture, hip, or vertebral fractures compared to ongoing BP users.