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Real-world evaluation of osteoporotic fractures using the Japan Medical Data Vision database

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Abstract

Summary

In Japanese patients who experienced an osteoporotic fracture, 10.8% and 18.6% had a subsequent fracture within 1 and 2 years of follow-up, respectively. Although the burden of hip and vertebral fractures has been reported widely, we found that patients with non-hip non-vertebral (NHNV) fractures had a 26% higher risk of subsequent fracture than patients with hip fractures; therefore, NHNV fractures should also be considered an important risk factor for subsequent fracture.

Introduction

To investigate imminent risk and odds of subsequent osteoporotic fractures and associated risk factors in patients who experienced an initial osteoporotic fracture.

Methods

Patients aged ≥ 50 years with ≥ 1 osteoporotic fracture were analyzed from Japan’s Medical Data Vision (MDV) database of claims from acute-care hospitals (January 2012–January 2017). Multivariable models were constructed to explore the impact of key comorbidities and medications on the subsequent fracture risk: Cox proportional hazards model for time to subsequent fracture and logistic regression models for odds of subsequent fracture within 1 and 2 years from index fracture.

Results

In total, 32,926 patients were eligible with a median follow-up duration of 12.3 months. The percentage of patients experiencing subsequent fractures was 14.1% across the study duration, and 10.8% and 18.6% in patients with 1 and 2 years of follow-up, respectively. In the Cox proportional hazards model, patients with vertebral or NHNV index fractures had a higher subsequent fracture risk than patients with a hip index fracture (adjusted hazard ratio [aHR] 1.11 and 1.26, respectively); subsequent fracture risk was lower in males than females (aHR 0.89). Patients with baseline claims for tranquilizers and glucocorticoids had a higher subsequent fracture risk than those without (aHR 1.14 and 1.08, respectively). Additionally, baseline claims for anti-Parkinson’s medications, alcoholism, and stage 4/5 chronic kidney disease were significantly associated with higher odds of subsequent fracture in the logistic regression models.

Conclusion

Several clinical and demographic factors were associated with a higher risk and odds of subsequent fracture. This may help to identify patients who should be prioritized for osteoporosis treatment.

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Data sharing statement

The data-sets analyzed in this study can be purchased from MDV. However, the authors cannot share the data with any third parties or make the data publicly available due to protections around the sharing of private health data.

Code availability

Analysis code is not publicly available; however, the authors are happy to provide further details of any aspects of the methodology on request.

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Acknowledgements

The authors thank Rebecca Costa for her support with data analysis and Choy Jian Yi for the medical writing and editorial services for this manuscript.

Funding

This study was sponsored by Amgen K.K. and Astellas Pharma Inc. Support for third-party writing assistance for this article, provided by Choy Jian Yi, BSc, Costello Medical, Singapore, was funded by Amgen K.K. and Astellas Pharma Inc. in accordance with Good Publication Practice (GPP3) guidelines (http://www.ismpp.org/gpp3).

Author information

Authors and Affiliations

  1. Yasuda Women’s University, Hiroshima, Japan

    Saeko Fujiwara

  2. Costello Medical, Boston, MA, USA

    Amy Buchanan-Hughes

  3. Costello Medical, Singapore, Singapore

    Alvin Ng

  4. Costello Medical, Manchester, UK

    Jennifer Page

  5. Amgen K.K., Tokyo, Japan

    Kenji Adachi

  6. Amgen Asia Holding Limited, Hong Kong, China

    Hong Li

Authors
  1. Saeko Fujiwara
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  2. Amy Buchanan-Hughes
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  3. Alvin Ng
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  4. Jennifer Page
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  5. Kenji Adachi
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  6. Hong Li
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Contributions

Substantial contributions to study conception and design: All; substantial contributions to analysis and interpretation of the data: All; drafting the article or revising it critically for important intellectual content: All; final approval of the version of the article to be published: All.

Corresponding author

Correspondence to Saeko Fujiwara.

Ethics declarations

Ethics approval and consent to participate

Patient data are de-identified at the hospital level before being incorporated into the MDV database, and the medical claims data retrieved from the database for this study were unlinkable to individual patients. Furthermore, as there was no active enrolment, follow-up, or direct data collection from individuals, ethics committee approval for this study was not necessary. Formal consent from patients for participation and publication was not required for this study.

Conflicts of interest

Saeko Fujiwara received consultation fees from Teijin Pharma Co. Amy Buchanan-Hughes, Alvin Ng and Jennifer Page are employees of Costello Medical, which was funded by Amgen to provide data analysis, research, writing and editorial services for this manuscript. Kenji Adachi is an employee of Amgen, and Hong Li was an employee of Amgen at the time of study conduct and manuscript development.

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Fujiwara, S., Buchanan-Hughes, A., Ng, A. et al. Real-world evaluation of osteoporotic fractures using the Japan Medical Data Vision database. Osteoporos Int 33, 2205–2216 (2022). https://doi.org/10.1007/s00198-022-06472-1

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