Yalin Deng

Oral bisphosphonates (BP) are considered the first-line therapy for osteoporosis treatment, and randomized controlled trials have demonstrated their sustained anti-fracture benefits. Guidelines recommend those at low fracture risk discontinue BP treatment after long-term use (3-5 years), also called a drug holiday, to reduce the risk of rare adverse events associated with prolonged treatment. However, limited research has investigated the optimal management of drug holiday and therapy switches leveraging nationally representative U.S. data sources. Without further evidence, patients may receive suboptimal care. The goal of the proposed study is to inform clinicians on appropriate deprescribing decisions to minimize fracture risks in older adults with osteoporosis. We aim to describe the trend of long-term BP use and assess the optimal management of treatment discontinuation and alternative therapies over time using a 20 percent sample of U.S. community-dwelling Medicare beneficiaries.