Are there differences between men and women prescribed bisphosphonate therapy in canadian subspecialty osteoporosis practices?

Abstract

OBJECTIVE:

To determine if there are differences between men and women referred for treatment of osteoporosis in Canada.

METHODS:

We performed an observational study of 1588 patients (163 men, 1425 women), 50 years of age and older, who were prescribed cyclic etidronate or alendronate for treatment of osteoporosis or osteopenia and had at least 2 years of followup registered in the Canadian Database for Osteoporosis and Osteopenia Patients (CANDOO). Comparisons of characteristics between men and women were performed using Pearson chi-square test, Student's t test, or a Kruskal-Wallis test, whichever was most appropriate.

RESULTS:

Mean baseline femoral neck and lumbar spine bone mineral densities were significantly higher in men than women at both the femoral neck and lumbar spine (p < 0.05, respectively). Men had double the rate of prevalent vertebral fractures (44%, 72/163) compared to women (22%, 315/1425; p < 0.001) and triple the rate of multiple prevalent vertebral fractures (10%, 17/163) compared to women (3%, 37/1425, p < 0.001). Furthermore, men were twice as likely as women to sustain a fracture within 2 years of starting treatment during observation in the CANDOO study (men: 4%, 7/163, women: 2%, 24/1425, p = 0.033).

CONCLUSION:

Osteoporosis may be under-recognized in men until the condition is at an advanced stage. A form of gender bias may exist in recognition and treatment (or referral for treatment) of osteoporosis in men.

• Authors: Anna M Sawka, Jonathan D Adachi, Alexandra Papaioannou, Lehana Thabane, George Ioannidis, K Shawn Davison, Wojciech P Olszynski, Jacques P Brown, David A Hanley, Tim M Murray, Robert G Josse, Rolf J Sebaldt, Annie Petrie, Alan Tenenhouse, Charles H Goldsmith
• Journal: The Journal of rheumatology (J Rheumatol) Vol. 31 Issue 10 Pg. 1993-5 (Oct 2004) ISSN: 0315-162X [Print] Canada
• PMID: 15468365 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Etidronic Acid
• Alendronate

Topics

• Aged
• Alendronate (therapeutic use)
• Canada
• Etidronic Acid (therapeutic use)
• Female
• Humans
• Male
• Middle Aged
• Osteoporosis (drug therapy)
• Prejudice
• Referral and Consultation
• Sex Factors