B. Ettinger et al., CLINIC VISITS AND HOSPITAL ADMISSIONS FOR CARE OF ACID-RELATED UPPER GASTROINTESTINAL DISORDERS IN WOMEN USING ALENDRONATE FOR OSTEOPOROSIS, American journal of managed care, 4(10), 1998, pp. 1377-1382
Citations number
11
Categorie Soggetti
Heath Policy & Services","Medicine, General & Internal
Context: About 1 in 3 women taking alendronate for osteoporosis report
gastrointestinal symptoms, a rate much higher than that found during
clinical trials.Objective: To establish the frequency of outpatient vi
sits and hospital admissions for acid-related upper gastrointestinal d
isorder (ARD) among women taking alendronate and to identify potential
risk factors. Methods: A retrospective database analysis identified 8
12 women with osteoporosis who had filled one or more 10-mg alendronat
e prescriptions from October 1995 through October 1996. Results: One h
undred (12.3%) of the 812 women received healthcare for ARD, a clinica
l encounter rate of 28.5 per 100 person-years. A reference group of 36
2,109 women from the same health plan had 17.6 ARD encounters per 100
person-years. Excluding women who had ARDs before receiving alendronat
e, alendronate users were 1.6 (95% CI=1.2, 2.7) times more likely to h
ave an ARD encounter than nonusers. Risk of having ARD increased with
age [users aged 70 years and older had a relative risk of 1.5 (95% con
fidence interval (CI) 1.0-2.30) compared with younger women] and with
concurrent use of nonsteroidal anti-inflammatory drugs (NSAIDS) (relat
ive risk 1.7, 95% CI 1.1-2.6). Conclusions: Elderly alendronate users
or those concurrently taking NSAIDS should be carefully monitored beca
use of their high risk of having ARD. Cost/benefit analyses of alendro
nate treatment for osteoporosis should include costs of treating ARD.