Journal
JOURNAL OF KOREAN MEDICAL SCIENCE
Volume 33, Issue 5, Pages -Publisher
KOREAN ACAD MEDICAL SCIENCES
DOI: 10.3346/jkms.2018.33.e38
Keywords
Hip Fractures; Diphosphonate; Incidence; Korea
Categories
Funding
- Seoul National University Bundang Hospital Research Fund [13-2017-009]
- Korea Human Technology Research Foundation [KOHTERF-2017-1]
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Background: Atypical femoral fracture (AFF) has been high-lightened, because it was associated with the long-term use of bisphosphonate. Comparing western countries, the incidence rate of AFF was unclear in East Asian patients. Our purposes were to estimate the incidence rate of radiologically defined AFF in Korea, and to determine the association between occurrence of AFF and long-term use of bisphosphonate. Methods: We conducted a hospital-based, retrospective cohort study in patients aged >= 45 years, who took bisphosphonate. The occurrence of AFF was estimated by using incidence rate, and the age-adjusted incidence rate to U.S. 2010 Census data. The association between occurrence of AFF and the duration of bisphosphonate use was examined. The cumulative probability of AFF was plotted per each duration of bisphosphonate use. Results: Among 10,338 individuals who took bisphosphonate, 13 patients with AFF following use of bisphosphonate were identified. The incidence rate was 85.9/100,000 person-years (95% confidence interval [CI], 50.2-146.9), and age-adjusted incidence rate was 72.7/100,000 person-years (95% CI, 29.1-175.8). In Poisson regression analysis, higher body mass index (BMI) was associated with an increased risk of AFF (relative risk, 1.2; 95% CI, 1.004-1.359). The cumulative probability of AFF increased abruptly when the duration of bisphosphonate use was 4 years or more. Conclusion: Among Korean patients, the incidence rate of AFF was on a par with those of western countries, and this can provide basic information to conduct further studies by evaluating risk and benefit of continuing bisphosphonate.
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