Abstract
Summary
Bisphosphonates are a first-line treatment for osteoporosis but require adequate renal function. We estimated the prevalence of renal impairment among osteoporotic women in Israeli. Approximately 2.3 % of women had renal impairment at a level that makes them inappropriate for bisphosphonate use, demonstrating the need for alternative therapies for osteoporosis treatment.
Purpose
The purpose of this study is to estimate the prevalence of renal impairment among postmenopausal osteoporotic women within a large Israeli health plan.
Methods
This was a retrospective analysis of Maccabi electronic medical records, including Israeli women aged ≥55 with either an osteoporosis diagnosis or osteoporosis-related fracture between January 1, 2007, and December 31, 2011. The estimated glomerular filtration rate (eGFR), which was calculated from the lowest serum creatinine levels reported during the study period, was used to classify stage 1–5 renal impairment: normal ≥90, mild 60–89, moderate 30–59, severe 15–29, and failure <15 mL/min/1.73 m2, respectively. Outcomes were distributions of renal impairment across the study population and stratified by age and osteoporosis-defining event.
Results
A total of 15,608 patients met all eligibility criteria. Patients with stage 1–5 renal function accounted for 25.2, 54.9, 18.5, 1.2, and 0.3 %, respectively, of all patients. Of osteoporotic patients, 2.3 % had eGFR levels (<35 mL/min/1.73 m2) that make them inappropriate for bisphosphonate use. This rate was 1.6 % among patients with an osteoporosis diagnosis and 3.8 % among patients with osteoporosis-related fracture. Within the group of renally impaired patients, older patients were overrepresented. Of the fracture group, patients with hip fractures had a higher prevalence of renal dysfunction (9.3 %) than those having vertebral fractures (3.2 %) or other fractures (2.0 %).
Conclusions
Among postmenopausal women with osteoporosis, 2.3 % had renal impairment which makes them inappropriate for bisphosphonate use in Israel.
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Acknowledgments
This analysis was funded by Merck & Co., Inc. Editorial assistance in the preparation of this manuscript was provided by Jennifer Klem, PhD, Klem Medical Communications, LLC.
Conflicts of interest
Jingbo Yu is an employee of Merck & Co., Inc. Inbal Goldshtein has no disclosures. Varda Shalev has no disclosures. Gabriel Chodick has no disclosures. Sophia-Ish Shalom has received research grants and consulting, advisory board, and lecture fees from Merck Sharp & Dohme Co. Ltd. Ofer Sharon is an employee of Merck Sharp & Dome Co. Ltd. Ankita Modi is an employee of Merck & Co., Inc.
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Yu, J., Goldshtein, I., Shalev, V. et al. Renal impairment among postmenopausal women with osteoporosis from a large health plan in Israel. Arch Osteoporos 10, 8 (2015). https://doi.org/10.1007/s11657-015-0210-y
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DOI: https://doi.org/10.1007/s11657-015-0210-y