Article Text

PDF
AB1058 Renal Impairment among Postmenopausal Women with Osteoporosis from A Large Health Plan in Israel
  1. J. Yu1,
  2. I. Goldshtein2,
  3. S. Ish-Shalom3,
  4. O. Sharon4,
  5. A. Modi5
  1. 1Global Health Outcomes, Merck & Co., Inc., Whitehouse Station, NJ, United States
  2. 2Maccabi Healthcare Services, Tel Aviv
  3. 3Technion Faculty of Medicine, Haifa
  4. 4MSD Israel, Petah Tikva, Israel
  5. 5Merck & Co., Inc., Whitehouse Station, NJ, United States

Abstract

Objectives To estimate the proportion of patients with renal impairment among postmenopausal osteoporotic women within a large health plan in Israel.

Methods This was a retrospective analysis of Maccabbi electronic medical records (EMR) in Israel. Women aged ≥55 years, with a recorded osteoporosis diagnosis or osteoporosis-related fracture (date for 1st such diagnosis was defined as index date) between 1/1/2007 and 12/31/2012, who were enrolled in health plan for ≥1 year prior to and after index were included. Patients' minimum serum creatinine level (Scr) during one year pre-index to one year post-index was utilized to calculate glomerular filtration rate (eGFR), using Modification of Diet in Renal Disease (MDRD) equation. Stage 1-5 of renal impairment was classified using the MDRD renal impairment staging system by eGFR: normal ≥90; mild 60 – 89; moderate 30– 59; severe 15 – 29, and failure<15 mL/min/1.73 m2 respectively.

Results 18,101 patients were included in the analysis. The mean age (± standard deviation [SD]) of these patients was 66.7±9.0 years, and 35.5% of patients had a fracture at index. Patients with renal function of stage 1-5 accounted for 21.7%, 47.3%, 14.3%, 15.9%, 1.0%, and 0.1% respectively of all patients. 2.3% of those patients had eGFR levels <35 mL/min/1.73 m2; the rate was 1.5% for patients with osteoporosis diagnosis and 3.9% for patients with fractures; the rate was higher among older patients aged ≥70 (4.3%) than younger patients (0.5%).

Conclusions This analysis showed that 2.3% of osteoporotic women had renal impairment (eGFR levels <35 mL/min/1.73 m2) to a level at which the commonly used bisphosphonates such as alendronate, risedronate and ibandronate are not recommended. This limitation indicates a need for therapeutic alternatives that have been demonstrated to reduce fracture risk in osteoporotic patients with severe renal insufficiency.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.2053

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.