Bisphosphonate use is associated with reduced fracture rates in a cohort of patients with Parkinson’s disease

Patients with Parkinson’s disease, often accompanied by osteoporosis, have a higher risk of osteoporotic fractures. However, a 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 7335 patients were selected for index regression model and 5806 patients were further selected for landmark model of 1 year after diagnosis of osteoporosis. Occurrence of osteoporotic fracture was set defined as outcome variable for both regression models. Regression analysis with a landmark model one year after the index diagnosis of osteoporosis showed that the use of bisphosphonates had a significant preventive effect on osteoporotic fractures (hazard ratio HR 0.83, 95% confidence interval CI 0.73–0.96, p = 0.012). 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.