Email updates

Keep up to date with the latest news and content from BMC Women's Health and BioMed Central.

Open Access Highly Accessed Research article

Fractures in women treated with raloxifene or alendronate: a retrospective database analysis

Shonda A Foster1*, Nianwen Shi2, Suellen Curkendall2, John Stock1, Bong-Chul Chu2, Russel Burge1, David R Diakun2 and John H Krege3

Author Affiliations

1 Eli Lilly and Company, Indianapolis, IN, USA

2 Truven Health Analytics, Bethesda, MD, USA

3 Lilly USA, LLC, Indianapolis, IN, USA

For all author emails, please log on.

BMC Women's Health 2013, 13:15  doi:10.1186/1472-6874-13-15

Published: 23 March 2013

Abstract

Background

Raloxifene and alendronate are anti-resorptive therapies approved for the prevention and treatment of postmenopausal osteoporosis. Raloxifene is also indicated to reduce the risk of invasive breast cancer in postmenopausal women with osteoporosis and in postmenopausal women at high risk of invasive breast cancer. A definitive study comparing the fracture effectiveness and rate of breast cancer for raloxifene and alendronate has not been published. The purpose of this retrospective cohort study was to evaluate fracture and breast cancer rates among patients treated with raloxifene or alendronate.

Methods

Females ≥45 years who initiated raloxifene or alendronate in 1998–2006 Truven Health Analytics MarketScan® Databases, had continuous enrollment 12 months prior to and at least 12 months after the index date, and had a treatment medication possession ratio ≥80% were included in this study. Rates of vertebral and nonvertebral fractures and breast cancer during 1, 3, 5, 6, 7, and 8 years of treatment with raloxifene or alendronate were evaluated. Fracture rates were adjusted for potential treatment bias using inverse probability of treatment weights. Multivariate hazard ratios were estimated for vertebral and nonvertebral fractures.

Results

Raloxifene patients had statistically significantly lower rates of vertebral fractures in 1, 3, 5, and 7 years and for nonvertebral fractures in 1 and 5 years. There were no statistically significant differences in the adjusted fracture rates between raloxifene and alendronate cohorts, except in the 3-year nonvertebral fracture rates where raloxifene was higher. Multivariate hazard ratios of raloxifene versus alendronate cohorts were not significantly different for vertebral and nonvertebral fracture in 1, 3, 5, 6, 7, and 8 years. Unweighted and weighted breast cancer rates were lower among raloxifene recipients.

Conclusions

Patients treated with alendronate and raloxifene had similar adjusted fracture rates in up to 8 years of adherent treatment, and raloxifene patients had lower breast cancer rates.

Keywords:
Vertebral fracture; Nonvertebral fracture; Breast cancer; Alendronate; Raloxifene