How do the top 10 known offending drug classes associated with decreased bone mineral density affect total shoulder arthroplasty outcomes?

Cole, Matthew W.; Waters, Timothy L.; Collins, Lacee K.; Ross, Bailey J.; Salas, Zachary; Savoie, Felix H.; O’Brien, Michael J.; Sherman, William F.

doi:10.1016/j.jse.2022.11.006

Cited by 3 publications

(4 citation statements)

References 31 publications

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“…Multiple (but not all) studies and meta-analyses found that usage of antipsychotics (typical and atypical), antidepressants (tricyclic and serotonin reuptake inhibitors), antiparkinsonian drugs or anticonvulsants was associated with a negative efect on BMD, higher falls and fracture risk including HF [139][140][141][142], as well as increased risk of acute kidney injury, CKD, hypertension, cardiovascular events, etc. [143][144][145][146].…”

Section: Prognostic Value Of Ckd and Related Factors For Predictingmentioning

confidence: 99%

Chronic Kidney Disease in Patients with Hip Fracture: Prevalence and Outcomes

Fisher,

Wang,

Smith

2024

International Journal of Clinical Practice

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Objective. Although the association between chronic kidney disease (CKD) and osteoporotic fractures is well established, data on CKD combined with hip fracture (HF) are scarce and controversial. We aimed to assess in patients with HF the prevalence of CKD, its impact on hospital mortality and length of stay (LOS) and to determine the prognostic value of CKD to predict hospital outcomes. Methods. Prospectively collected clinical data were analysed in 3623 consecutive HF patients aged ≥65 years (mean age 83.4 ± 7.50 [standard deviation] years; 74.4% females). Results. CKD among older patients with HF is highly prevalent (39.9%), has different clinical characteristics, a 2.5-fold higher mortality rate, and 40% greater risk of prolonged LOS. The strongest risk for a poor outcome was advanced age (>80 years). The risk of death substantially increases in combination with chronic disorders, especially coronary artery disease, anaemia, hyperparathyroidism, and atrial fibrillation; models based only on three variables—CKD stage, age >80, and presence of a specific chronic condition—predicted in-hospital death with good discrimination capability (AUC ≥ 0.700) and reasonable accuracy, the number needed to predict ranged between 5.7 and 14.5. Only 12% of HF patients received osteoporotic drugs prefracture. Conclusion. In HF patients with CKD, the risk of adverse outcomes largely increases in parallel with worsening kidney function and, especially, in combination with comorbidities; models based on three admission variables predict a fatal outcome. Assessment of renal function is essential to preventing osteoporotic fractures.

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Section: Prognostic Value Of Ckd and Related Factors For Predictingmentioning

confidence: 99%

Chronic Kidney Disease in Patients with Hip Fracture: Prevalence and Outcomes

Fisher,

Wang,

Smith

2024

International Journal of Clinical Practice

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“…323 Indeed, the use of SSRIs has been related to a negative impact on bone health, and SSRIs have been associated with significantly higher rates of all-cause revision (OR 1.24) or aseptic revision (OR 1.24) after total shoulder arthroplasty. 324 A recent review and metanalysis observed a significant decrease in bone mineral density after using SSSRIs with a mean effect of 0.28 (95% CI = 0.08, 0.39). 313 A retrospective comparison did not show a significant difference in the time of bone fractures to union between patients with chronic SSRI use and patients who had not been on SSRIs (time to heal 6.1 vs. 6.0 months).…”

Section: Selectiveserotoninreuptakeinhibitorsmentioning

confidence: 99%

“…In the orthopedic field, long-term use of loop diuretic medication has been associated with significantly higher rates of all-cause revision of total shoulder arthroplasty (OR 1.44) and aseptic revision (OR 1.43). 324 The possible mechanisms by which antihypertensives (AHTNs) impact bone metabolism may be related to the inhibition of the catabolic effect of osteoclasts by blocking their β2 adrenergic receptors (beta-blockers), to the increase in bone formation due to the higher calcium absorption at the distal convoluted tubule (thiazides) or by shifting the balance toward bone formation by blocking the renin-angiotensin system (ACE inhibitors). 326,353 In a review about medication related to dental implant failure, only one study on AHTNs reached the inclusion criteria.…”

Section: Antihypertensivesmentioning

confidence: 99%

“…Additionally, the use of SSRIs in a murine model delayed bone healing by reducing osteoblastic differentiation and mineralization 323 . Indeed, the use of SSRIs has been related to a negative impact on bone health, and SSRIs have been associated with significantly higher rates of all‐cause revision (OR 1.24) or aseptic revision (OR 1.24) after total shoulder arthroplasty 324 . A recent review and metanalysis observed a significant decrease in bone mineral density after using SSSRIs with a mean effect of 0.28 (95% CI = 0.08, 0.39) 313 .…”

Section: Drug‐related Factors Affecting Bone Metabolismmentioning

confidence: 99%

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Emerging factors affecting peri‐implant bone metabolism

Insua,

Galindo‐Moreno,

Miron

et al. 2023

Periodontology 2000

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Implant dentistry has evolved to the point that standard implant osseointegration is predictable. This is attributed in part to the advancements in material sciences that have led toward improvements in implant surface technology and characteristics. Nonetheless, there remain several cases where implant therapy fails (specifically at early time points), most commonly attributed to factors affecting bone metabolism. Among these patients, smokers are known to have impaired bone metabolism and thus be subject to higher risks of early implant failure and/or late complications related to the stability of the peri‐implant bone and mucosal tissues. Notably, however, emerging data have unveiled other critical factors affecting osseointegration, namely, those related to the metabolism of bone tissues. The aim of this review is to shed light on the effects of implant‐related factors, like implant surface or titanium particle release; surgical‐related factors, like osseodensification or implanted biomaterials; various drugs, like selective serotonin reuptake inhibitors, proton pump inhibitors, anti‐hypertensives, nonsteroidal anti‐inflammatory medication, and statins, and host‐related factors, like smoking, diet, and metabolic syndrome on bone metabolism, and aseptic peri‐implant bone loss. Despite the infectious nature of peri‐implant biological complications, these factors must be surveyed for the effective prevention and management of peri‐implantitis.

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