(C-094) Osteoporosis Pharmacotherapy in people with and without Parkinson’s disease in Finland

Background: Due to higher risks of both falling and osteoporosis, Parkinson’s disease (PD) is associated with a doubled risk of hip fracture. Previous reports suggest under-recognition of osteoporosis among persons with PD. However, limited evidence was available on whether anti-osteoporosis medication use changes with the progression of PD or the occurrence of hip fractures.

Objectives: To assess the annual prevalence of anti-osteoporosis medications among persons with and without PD in relation to diagnosis of PD and hip fractures.

Methods: Using our nationwide healthcare registries, we identified all persons diagnosed with incident PD between 2000 and 2009 in Finland and 1:2 age- and sex-matched comparison persons. Persons with previous hip fractures were excluded. Dispensings of anti-osteoporosis medications were assessed for each year between 5 years before and 10 years after PD diagnosis, and between 5 years before and 5 years after the incident hip fractures. Annual prevalence was calculated as the number of persons dispensed an anti-osteoporosis medication divided by the number of individuals with ≥60 days in the community within that year for each cohort.

Results: Among 33,153 persons in our matched cohort, the annual prevalence of anti-osteoporosis medications was higher in persons with PD than those without PD, starting from 3 years before the diagnosis of PD (PD: 3.62%, 95% confidence interval [CI] 3.28%-3.98%; without PD: 2.91%, 95% CI 2.70%-3.14%), and continued to diverge until 10 years after diagnosis (PD: 7.14%, 95% CI 6.47%-7.85%; without PD: 3.52%, 95% CI 3.15%-3.93%). However, among individuals with incident hip fractures (1,475 [13%] persons with PD and 1,371 [6%] persons without PD), the annual prevalence before and after hip fractures was similar among persons with and without PD, with peak annual prevalence in the first year after hip fracture (PD: 20.3%, 95% CI 18.0%-22.8%; without PD: 21.0%, 95% CI 18.5%-23.6%).

Conclusions: Contrary to reports on under-treatment in persons with Parkinson’s disease, our study found similar prevalence of anti-osteoporosis medication usage before and after their hip fractures among Finns with and without Parkinson’s disease. Additional preventive measures such as regular review of fall risk may be needed to mitigate the doubled risk of hip fracture in PD.