SAT-LB092 Adherence to Weekly Alendronate Predicts Mortality in Male US Military Veterans

Background: The use of oral bisphosphonates in osteoporosis is associated with a lower rate of all-cause mortality, however, data are primarily available on postmenopausal women. It is unknown if poor adherence to bisphosphonates affects mortality in men. This study examines the association between weekly alendronate adherence and mortality in a male Veteran cohort. Methods: A retrospective cohort was generated from VA databases selecting Veterans who were initiated on weekly alendronate and had at least 2 years of follow up. Individuals had an identifiable reason for prevention or treatment of osteoporosis including index bone mineral density T-score ≤ -1 at total hip or lumbar spine, diagnosis of prostate cancer, evidence of a fracture, or diagnosis of osteoporosis or osteopenia. Adherence was measured by Medication Possession Ratio (MPR) calculated as the percentage of days’ supply for all fills divided by the number of days in the observation period. Good adherence was defined as a year one MPR ≥80%. A cox proportional hazard model was constructed to assess the association between adherence and mortality, adjusting for age, history of rheumatoid arthritis, alcohol abuse, tobacco use, use of oral glucocorticoids or acid suppression therapy. Results: The cohort included 706 male veterans between the ages of 50 and 90 years of age. After the initial required two-year follow-up for inclusion, the median follow up was 3.24 (interquartile range 1.14-5.35) years. Out of 706 veterans, 367 had MPR <80% and 339 had MPR ≥80%. Death occurred in 129 vs 105 (35.2% vs 31.0%), for year one MPR <80% vs ≥80%, respectively [HR 0.73; 95% CI 0.56- 0.95, P=0.02]. Other factors such as history of rheumatoid arthritis, alcohol abuse, tobacco use, use of oral glucocorticoids or acid suppression therapy were not associated with higher mortality. Conclusion: Adherence to weekly alendronate in the first year of treatment was associated with lower rate of mortality in male veterans. Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. Abstracts presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.