Patients with Parkinson’s Disease Seem to Have Preventive Effect for Osteoporotic Fractures with the Use of Bisphosphonate: A Nationwide Cohort Study

Patients with Parkinson’s disease, especially often combined with osteoporosis, have higher risk of osteoporotic fracture. However, large cohort study assessing the preventive effect of bisphosphonates for osteoporotic fracture on patients with Parkinson’s disease is scarce. This retrospective cohort study included nearly whole population of South Korea during 2002 to 2018 from the national patient database of Korea National Health Insurance Service. Of 608,202 patients with Parkinson’s disease, a total of 7,335 patients were selected for index regression model and 5,806 patients were further selected for landmark model of one-year after diagnosis of osteoporosis. Occurrence of osteoporotic fracture was set as outcome variable for both regression models. Compliant use of bisphosphonates showed significant preventive effect for osteoporotic fracture (hazard ratio = 0.83, P = 0.012) in regression analysis with landmark model of one-year after index diagnosis of osteoporosis. In index regression model, higher age, larger waist circumference, smoking, and history of lymphoma were significant risk factors of osteoporotic fractures. Higher weight and higher physical activity score were significant preventative factors. In the regression analysis with landmark model with 5806 patients, higher age, heavy alcohol consumption, smoking, and history of solid tumor were significant risk factors of osteoporotic fractures. Higher weight was a significant preventative factor.