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Abstract Number: 2256

Temporal Increases in Side Effect Concerns of Osteoporosis Medications Among Women with Previous Fractures

Maria I. Danila1, Elizabeth J. Rahn2, Amy S. Mudano1, Ryan Outman3, Peng Li4, David T. Redden4, Fred A. Anderson5, Susan L. Greenspan6, Andrea Z. LaCroix7, Jeri W. Nieves8, Stuart L. Silverman9, E.S. Siris10, Nelson B. Watts11, Sigrid Ladores12, Karen Meneses12, Jeffrey R. Curtis13 and Kenneth Saag13, 1University of Alabama at Birmingham, Birmingham, AL, 2Department of Medicine, Division of Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, 3Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, 4Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, 5University of Massachusetts Medical School, Worcester, MA, 6Medicine, University of Pittsburgh, Pittsburgh, PA, 7Group Health Cooperative, Seattle, WA, 8Helen Hayes, West Haverstraw, NY, 9Cedars-Sinai Medical Center, Los Angeles, CA, 10Columbia University Medical Center, New York, NY, 11University of Cincinnati, Cincinnati, OH, 12Nursing, University of Alabama at Birmingham, Birmingham, AL, 13Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: Adverse events, fractures and osteonecrosis of the jaw

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Session Information

Date: Tuesday, November 7, 2017

Title: Patient Outcomes, Preferences, and Attitudes Poster III

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: High-consequence, albeit rare, adverse side effects of osteoporosis medication raise patients’ risk perceptions and contribute to non-adherence. In the past decade, fears of osteonecrosis of the jaw (ONJ) and atypical femoral fractures (AFF) have been increasingly reported as barriers to both the initiation of and adherence to osteoporosis medications. We examined the temporal prevalence of self-reported concern about ONJ and AFF as reason for discontinuation of osteoporosis medication.

Methods: Activating Patients at Risk for OsteoPOroSis (APROPOS) enrolled US women from the Global Longitudinal Study of Osteoporosis (GLOW) with previous self-reported fractures and no current use of osteoporosis medication. Using mailed surveys in 2010 (T1), 2012 (T2) and 2013 (T3), women were asked whether they discontinued osteoporosis medication in the prior year because of concerns about ONJ at three time points (T1, T2, T3) and AFF at two time points (T2, T3). We calculated the proportion of women reporting fears of ONJ and AFF among those who discontinued osteoporosis medication, and compared the proportions using chi-square tests.

Results: A total of 833 women discontinued osteoporosis treatment at three time points,T1 (N = 255), T2 (N = 471), and T3 (N= 107), respectively. There were no differences in the demographic characteristics between groups. The proportion of women reporting concerns of ONJ was 18.4% (T1), 26.7% (T2) and 64.5% (T3), while 23.5% (T2) and 60.7% (T3) reported fear of AFF as reason to discontinue osteoporosis treatment. These differences were statistically significant (p<0.0001) for all comparisons.

Conclusion: The proportion of women reporting concerns of ONJ and AFF increased over time among those women who discontinue osteoporosis medications. Strategies are needed to help patients balance risks and benefits given a significant and temporally growing concern of rare bisphosphonate side effects.


Disclosure: M. I. Danila, None; E. J. Rahn, None; A. S. Mudano, None; R. Outman, None; P. Li, None; D. T. Redden, None; F. A. Anderson, Millenium Pharmaceuticals, 5; S. L. Greenspan, Amgen, 2,Lilly, 2; A. Z. LaCroix, Amgen, Pfizer, Sermonix, 9; J. W. Nieves, None; S. L. Silverman, Amgen, Lilly, 2,Amgen, 5; E. S. Siris, None; N. B. Watts, OsteoDynamics, 1,Shire, 2,OsteoDynamics, 4,AbbVie, Amgen, Janssen, Merck, Radius, Sanofi, 5,Amgen, Shire, 9; S. Ladores, None; K. Meneses, None; J. R. Curtis, Amgen, 2,Amgen, 5; K. Saag, Amgen, Lilly, Merck, 5,Amgen, Lilly, Merck, 2.

To cite this abstract in AMA style:

Danila MI, Rahn EJ, Mudano AS, Outman R, Li P, Redden DT, Anderson FA, Greenspan SL, LaCroix AZ, Nieves JW, Silverman SL, Siris ES, Watts NB, Ladores S, Meneses K, Curtis JR, Saag K. Temporal Increases in Side Effect Concerns of Osteoporosis Medications Among Women with Previous Fractures [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/temporal-increases-in-side-effect-concerns-of-osteoporosis-medications-among-women-with-previous-fractures/. Accessed .
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