Initiating treatment for osteoporosis may reduce the risk of death in adults with epilepsy

Disclosures: Whitney does not report any relevant financial disclosure.

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Adults with epilepsy who started medication for osteoporosis had a less than 3-year risk of death compared to those who did not take medication, according to data from a study published in BONE.

“The main finding of this study suggests that osteoporosis drugs are associated with a 30% reduction in the risk of 3-year mortality in adults with epilepsy, with the effect noticeable after 6 months. which was the first time to track mortality in the current study. ” Daniel G. Whitney, PhD, an assistant professor in the Department of Physical Medicine and Rehabilitation at the University of Michigan, wrote in a study published in BONE. “Although the risk of 3-year mortality was elevated by about 42% to 49% in adults with epilepsy compared to those without epilepsy, a qualitative assessment may suggest that the difference in mortality risk is starting to grow. apparent about 1.3 years after onset. osteoporosis drugs. This assessment of the evolution of time may indicate potential windows of opportunity for additional and / or revised interventions to further reduce the risk of mortality. “

Adults with epilepsy had a lower death rate ratio 3 years after starting osteoporosis treatment compared to those with epilepsy not receiving osteoporosis treatment. The data comes from Whitney DG. BONE. 2021; doi: 10.1016 / j.bone.2021.116003.

Whitney conducted a retrospective observational cohort study using claims data from the Optum Clinformatics Data Mart database. Baseline data was collected from 2012 to September 2014, and mortality data was collected up to September 2017. Data was extracted for adults aged 50 or older who had 12 months of continuous enrollment until start of follow-up, had 6 months of continuous enrollment and were alive after the start date of follow-up and used health care services for at least 2 days during the reference period. Participants were considered epileptic if they had at least one claim for epilepsy and recurrent seizures on at least 2 separate days within a 12-month period. Osteoporosis drugs were identified during the first outpatient pharmacy claim between 2013 and September 2014. Tracking of osteoporosis drug users began on the date of their first drug claim. Adults who did not use osteoporosis medications were randomly assigned a follow-up start date between 2013 and September 2014.

There were 733 adults with epilepsy who were new users of osteoporosis drugs included in the analysis. The cohort was compared to a group of 2932 adults with epilepsy who were not using osteoporosis drugs, and another group of 2932 non-epileptic adults who were new users of osteoporosis drugs. During follow-up, 7.2% of people with epilepsy using osteoporosis drugs died, 10% died in the non-user group, and 5.2% of adults without epilepsy who were using the drugs died.

Adults with epilepsy who were new users of osteoporosis drugs had a lower incidence rate ratio (IRR) of mortality than those who had epilepsy and were not using drugs (IRR = 0.69; 95% CI: 0.52-0.93). People with epilepsy who used osteoporosis drugs had a higher death rate than adults who did not have epilepsy (IRR = 1.42; 95% CI: 1.04-1.94). Results were similar when groups were disaggregated by sex and after adjusting for covariates.

Before adjusting for covariates, participants with epilepsy who used bisphosphonates had a lower risk of mortality than those who used other drugs (HR = 0.45; 95% CI: 0.25-0.8 ). After adjusting for covariates, the association was not significant.

“Although there was some evidence that bisphosphonate treatment was associated with a lower risk of mortality only in adults with epilepsy in the exploratory analysis, future studies are needed to confirm this conclusion and perform a more comparative analysis. complete with other osteoporosis medications, ”Whitney wrote.

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