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Large Joints Feature

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Women on Bisphosphonates: 25% Lower Risk of Knee Replacement

Elizabeth Hofheinz, M.P.H., M.Ed. • Thu, December 21st, 2017

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Tuhina Neogi, M.D., Ph.D.

For a subset of women—older ladies—taking bisphosphonates may help avoid future knee replacement.

The study, “Effect of bisphosphonates on knee replacement surgery” appears in the December 11, 2017 online edition of Annals of the Rheumatic Diseases.

Tuhina Neogi, M.D., Ph.D., professor of Medicine and of Epidemiology at the Boston University School of Medicine and co-author of the study, told OTW, “We were interested in learning more about the potential for bisphosphonates as a treatment for osteoarthritis (OA). Studies to date have had conflicting results.”

“Further, traditional clinical trials are typically not long enough to determine whether there may be any unanticipated long-term effects that could be potentially detrimental to osteoarthritis joints. We postulated that if bisphosphonates were to have a benefit in osteoarthritis, we may see that people taking bisphosphonates had lower rates of getting their knees replaced than those not taking bisphosphonates.”

“Such a finding would suggest that bisphosphonates were beneficial in preventing osteoarthritic knees from progressing to a severe stage requiring surgery.”

“We were able to leverage a large administrative health database from the UK that has anonymized health data on >12 million patients collected as part of their routine care by their general practitioners, providing a ‘real world’ evaluation in quite a large sample.”

“Such a study would not otherwise be feasible in a traditional clinical trial setting since they are typically not long enough or large enough to evaluate an endpoint such as joint replacement. We identified women aged 50-89 with a new diagnosis of knee osteoarthritis, and from among these women, we matched women who were newly prescribed bisphosphonates after their knee OA diagnosis with those women who were not. We performed a propensity score matched analysis with several sensitivity analyses to minimize confounding bias.”

“We found that women who were on bisphosphonates had about a 25% lower risk of going on to have a knee replacement surgery than those who were not on bisphosphonates over an average of three years of follow-up.”

“We believe these findings support the promise of bisphosphonates and other drugs that target bone in the management of osteoarthritis, and support the need for further development and definitive treatment trials in osteoarthritis. Because we studied older women, whether the same findings would be noted in men or younger people is not known.”

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