title: Use of oral bisphosphonates in primary prevention of fractures in postmenopausal women: a population-based cohort study.
abstract: OBJECTIVE
  To compare incidence of first osteoporotic fracture in two cohorts of postmenopausal women, one treated with bisphosphonates and the other only with calcium and vitamin D.
  
  
  METHODS
  Retrospective population cohort study with paired matching based on data from electronic health records.
  
  
  METHODS
  Women aged 60 years and older in 2005, from 21 primary care centers in a healthcare region of Spain.
  
  
  METHODS
  Two groups of women aged 60 years and older (n = 1208), prescribed either calcium and vitamin D (CalVitD) or bisphosphonates (BIPHOS) with or without calcium and vitamin D, were compared for the end point of first recorded osteoporotic-related fracture, with 5-years follow-up.
  
  
  METHODS
  Incidence of first fracture: Vertebral fracture, osteoporosis with pathological fracture, fracture of the upper humeral epiphysis, fracture of the lower radial epiphysis, or femur fracture.
  
  
  RESULTS
  Estimated 10-year risk of fracture was 11.4% (95% confidence interval: 9.6 to 13.2), 11.8% (9.2 to 14.3) in the BIPHOS group and 11.1% (8.6 to 13.6) in the CalVitD group. No significant differences were found between groups in total fractures (Hazard ratio = 0.934 (0.67 to 1.31)) or location (vertebral, femoral, radial or humeral).
  
  
  CONCLUSIONS
  In postmenopausal women, bisphosphonates have not been shown to better decrease risk of first fracture compared with calcium and vitamin D therapy alone.
authors: Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Lleida, Spain; School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Valles, Spain.
authors: Jordi
authors: J
authors: Real
authors: Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Lleida, Spain; Primer de Maig Center, Institut Català de la Salut, Lleida, Spain.
authors: Gisela
authors: G
authors: Galindo
authors: Catalan Health Departament, Lleida, Spain.
authors: Leonardo
authors: L
authors: Galván
authors: Bordeta-Magraners Center, Institut Català de la Salut, Lleida, Spain.
authors: María Antonia
authors: MA
authors: Lafarga
authors: Bordeta-Magraners Center, Institut Català de la Salut, Lleida, Spain.
authors: María Dolors
authors: MD
authors: Rodrigo
authors: Cappont Center, Institut Català de la Salut, Lleida, Spain.
authors: Marta
authors: M
authors: Ortega
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D002136:Calcium, Dietary / Q000008:administration & dosage; D015331:Cohort Studies; D004164:Diphosphonates / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy*; D058866:Osteoporotic Fractures / Q000453:epidemiology / Q000517:prevention & control*; D017063:Outcome Assessment, Health Care; D011322:Primary Prevention; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D014807:Vitamin D / Q000008:administration & dosage
chemical_list: D050071:Bone Density Conservation Agents; D002136:Calcium, Dietary; D004164:Diphosphonates; D014807:Vitamin D