Association Between Prior Bisphosphonate Use and COVID-19-Related Outcomes
Thompson J1, Wang Y2, Dreischulte T3, Barreiro O2, Gonzalez R2, Hanč P2, Matysiak C2, Neely H2, Rottenkolber M3, Haskell T1, Endres S3, von Andrian U2
1Cerner Enviza, Malvern, PA, USA, 2Harvard Medical School, Boston, MA, USA, 3LMU, Munich, Germany
OBJECTIVES: Bisphosphonates (BPs), a class of drugs used to prevent bone loss, exert multifaceted immuno-modulatory activities. The objective of this study was to assess the association between prior BP-use and COVID-19-related outcomes.
METHODS: Closed-claims data from Komodo Health were used to identify patients with continuous medical and prescription insurance-enrollment during the study period 1/1/2019-6/30/2020 and no missing demographic information. BP-users, identified as patients with ≥1 BP-claim during the pre-observation period 1/1/2019-2/29/2020, were propensity-score-matched to BP-nonusers based on demographic and clinical characteristics. The association between BP-use and the odds ratio (OR) for SARS-CoV-2 testing, COVID-19 diagnosis, and COVID-19-related hospitalization during the observation period 3/1/2020-6/30/2020 were assessed using multivariable-logistic regression controlling for demographic/clinical characteristics. Sensitivity analyses performed included: restricting to females aged >50 diagnosed with osteoporosis and matching an active-control cohort of non-BP bone-medication-users to BP-users within state/insurance-type; assessing the relationship between use of other preventive-medications (statins, antihypertensives, antidiabetics, antidepressants), including impact of BP-use within users/nonusers of other preventive-medications, on COVID-19-related outcomes; and evaluating the effect of BP-use on positive-control outcomes (acute bronchitis, pneumonia) assessed 7/1/2019-12/31/2019 among BP-users 1/1/2019-6/30/2019 and their matched BP-nonuser-pair.
RESULTS: 7,906,603 patients met core eligibility criteria, of which 450,366 BP-users were identified and matched to 450,366 BP-nonusers. Compared to BP-nonusers, BP-users displayed a lower odds for SARS-CoV-2 testing (OR=0.22;95%CI:0.21-0.23;p<0.001), COVID-19 diagnosis (OR=0.23;95%CI:0.22-0.24;p<0.001), and COVID-19-related hospitalization (OR=0.26;95%CI:0.24-0.29;p<0.001). Consistent results were found comparing BP-users to non-BP bone-medication-users [(SARS-CoV-2 testing (OR=0.28;95%CI:0.23-0.35;p<0.001), COVID-19 diagnosis (OR=0.40;95%CI:0.32-0.49;p<0.001), COVID-19-related hospitalization (OR=0.45;95%CI:0.26-0.75;p=0.003)]. Use of other preventive-medications did not display similarly-consistent effects on COVID-19-related outcomes, though the impact of BP-use was maintained within users/nonusers of other preventive-medications. BP-use was also associated with a decreased odds of medical-services for acute bronchitis (OR=0.23;95%CI:0.22-0.23;p<0.001) or pneumonia (OR=0.32;95%CI:0.31-0.34;p<0.001) in 2019.
CONCLUSIONS: Prior BP-use was associated with a reduced odds of COVID-19-related outcomes during the initial wave of the pandemic in 2020.
Conference/Value in Health Info
Value in Health, Volume 25, Issue 6, S1 (June 2022)
Epidemiology & Public Health, Study Approaches
No Additional Disease & Conditions/Specialized Treatment Areas